Doctors often don't disclose all possible risks to patients before treatment

August 8, 2012 in Health

Most informed consent disputes involve disagreements about who said what and when, not stand-offs over whether a particular risk ought to have been disclosed. But doctors may "routinely underestimate the importance of a small set of risks that vex patients" according to international experts writing in this week's PLOS Medicine.

Increasingly, doctors are expected to advise and empower patients to make rational choices by sharing information that may affect , including risks of adverse outcomes. However, authors from Australia and the US led by David Studdert from the University of Melbourne argue that doctors, especially surgeons, are often unsure which clinical risks they should disclose and discuss with patients before treatment.

To understand more about the clinical circumstances in which disputes arise between doctors and patients in this area, the authors analyzed 481 and patient complaints from Australia involving of deficiencies in the process of obtaining .

The authors found that 45 (9%) of the cases studied were disputed duty cases—that is, they involved head-to-head disagreements over whether a particular risk ought to have been disclosed before treatment. Two-thirds of these disputed duty cases involved surgical procedures, and the majority (38/45) of them related to five specific outcomes that had quality of life implications for patients, including chronic pain and the need for re-operation.

The authors found that the most common justifications doctors gave for not telling patients about particular risks before treatment were that they considered such risks too rare to warrant discussion or the specific risk was covered by a more general risk that was discussed.

However, nine in ten of the disputes studied centered on factual disagreements—arguments over who said what, and when. The authors say: "Documenting consent discussions in the lead-up to surgical procedures is particularly important, as most informed consent claims and complaints involved factual disagreements over the disclosure of operative risks."

The authors say: "Our findings suggest that doctors may systematically underestimate the premium patients place on understanding certain risks in advance of treatment."

They conclude: "Improved understanding of these situations helps to spotlight gaps between what patients want to hear and what doctors perceive patients want—or should want—to hear. It may also be useful information for eager to avoid medico-legal disputes."

More information: Bismark MM, Gogos AJ, Clark RB, Gruen RL, Gawande AA, et al. (2012) Legal Disputes over Duties to Disclose Treatment Risks to Patients: A Review of Negligence Claims and Complaints in Australia. PLoS Med 9(8): e1001283. doi:10.1371/journal.pmed.1001283

Journal reference: PLoS Medicine search and more info website

Provided by Public Library of Science search and more info website

not rated yet  

Filter


Move the slider to adjust rank threshold, so that you can hide some of the comments.


Display comments: newest first

Skepticus
Aug 08, 2012

Rank: not rated yet
The same thing happens all the time with car mechanics. After all, they are all in businesses of fixing things for a fee.
Rank not rated yet
Relevant PhysicsForums posts

More news stories

ER docs are key to reducing health care costs

Emergency physicians are key decisionmakers for nearly half of all hospital admissions, highlighting a critical role they can play in reducing health care costs, according to a new report from the RAND Corporation.

Health created 1 hour ago | popularity not rated yet | comments 0

New research identifies risks, interventions for children's GI health

An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).

Health created May 18, 2013 | popularity not rated yet | comments 0 | with audio podcast

Youth who have their first drink during puberty have higher levels of later drinking

Research shows that the earlier the age at which youth take their first alcoholic drink, the greater the risk of developing alcohol problems. Thus, age at first drink (AFD) is generally considered a powerful predictor of ...

Health created May 17, 2013 | popularity not rated yet | comments 0

British MPs concerned about parliamentary boozing

One quarter of British lawmakers believe there is an "unhealthy" drinking culture in the Houses of Parliament, according to a survey published on Friday.

Health created May 17, 2013 | popularity not rated yet | comments 0

Patient openness to research can depend on race and sex of study personnel

Researchers at the University of Cincinnati (UC) have found that the race and sex of study personnel can influence a patient's decision on whether or not to participate in clinical research.

Health created May 17, 2013 | popularity not rated yet | comments 0


Treatment of sleep apnea improves glucose levels in prediabetes

Optimal treatment of sleep apnea in patients with prediabetes improves blood sugar (glucose) levels and thus can reduce cardiometabolic risk, according to a study to be presented at the ATS 2013 International Conference in ...

Whole-cell vaccine was more effective than acellular vaccine during CA pertussis outbreak

Whole-cell pertussis vaccines were more effective at protecting against pertussis than acellular pertussis vaccines during a large recent outbreak, according to a new Kaiser Permanente study published in Pediatrics.

Blame your parents for bunion woes

A novel study reports that white men and women of European descent inherit common foot disorders, such as bunions (hallux valgus) and lesser toe deformities, including hammer or claw toe. Findings from the Framingham Foot ...

Genetic diversity within tumors predicts outcome in head and neck cancer

A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue ...

Molecular marker from pancreatic 'juices' helps identify pancreatic cancer

Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...

Commonly used catheters double risk of blood clots in ICU and cancer patients

Touted for safety, ease and patient convenience, peripherally inserted central catheters have become many clinicians' go-to for IV delivery of antibiotics, nutrition, chemotherapy, and other medications.