Surgical Informed Consent in Children: A Systematic Review

• Published in: The Journal of surgical research Vol. 213; pp. 191 - 198
• Main Authors: Chotai, Pranit N., MD, Nollan, Richard, PhD, MLS, Huang, Eunice Y., MD, MS, Gosain, Ankush, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2017
• Subjects: Attitude of Health Personnel; Child; Communication; Consent; Decision Making; Decisional conflict; Humans; Informed consent; Parental; Parental Consent - ethics; Parental Consent - psychology; Parents - psychology; Patient centered; Pediatric; Professional-Family Relations - ethics; Shared decision-making; Surgeons - ethics; Surgeons - psychology; Surgery; Surgical Procedures, Operative - ethics; Surrogate; shared decision making; informed consent; decisional conflict; surrogate; consent; communication; patient centered; parental; surgery; pediatric; Parental; Consent; Surgery; Informed consent; Patient centered; Decisional conflict; Surrogate; Pediatric; Communication; Shared decision-making
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2017.02.047

Abstract Purpose To analyze current literature on surgeon and parents’ understanding and role in the informed consent process for children undergoing surgery. Methods A systematic database search (Medline, EMBASE, PsycINFO, and EBM Reviews) was performed to identify manuscripts concerning any aspect of the surgical informed consent for children undergoing an invasive procedure. Articles analyzing informed consent in research studies, non-English language manuscripts, review articles, case reports/series, letters/commentaries and dentistry/nursing related articles were excluded. Articles meeting inclusion criteria were analyzed to identify common themes related to the process of informed consent. Results 178 articles were identified on primary search, after removing duplicates and screening titles for relevance, 83 abstracts were reviewed. 32 additional abstracts were identified by secondary search. 12/115 articles met inclusion criteria. Analysis identified 5 different study themes. Information delivered during consent (Content) was studied in 5 (42%) articles, 3 (25%) studied the mechanics or delivery of the information (Delivery), 3 (25%) studied parent participation and discussion (Interchange), 6 (50%) articles discussed surgeons’ perceptions or the parents’ ability to understand or recall the information (Comprehension), and 5 (42%) articles evaluated surgeon or parent satisfaction or anxiety (Satisfaction). None of the articles studied all five categories. Conclusions Studies of the surgical informed consent process in children are scarce. Prospective studies evaluating surgeon and parent perception regarding the Content, Delivery, and Interchange of information as well as Comprehension and Satisfaction are needed to understand barriers to the surgeon-patient relationship and to optimize the informed consent process in children undergoing surgery.