Improving the Informed Consent Process
As part of the informed consent process before a surgery, an anesthesiologist talks to the patient and parents about the type of anesthesia planned, as well as the benefits and risks of anesthesia. Consent in this setting must be obtained in a matter of minutes and often on the anesthesiologist’s first meeting with the patient or a surrogate decision maker. While obtaining informed consent, the anesthesiologist is also trying to establish rapport with the patient and the patient’s family, which involves being sympathetic to their needs and fears, providing reassurance, and setting a calm tone in a busy, sometimes noisy environment. Time pressure may cause anesthesiologists to curtail their discussions as well as constrain their ability to establish rapport. There is an inherent tension in trying to accomplish two distinct things at once, especially when the appropriate tone and type of information conveyed for these two goals (establishing rapport versus informing about the anesthetic plan) are quite different.
Pediatric anesthesiologist and bioethics faculty Dr. Kate Gentry, along with bioethics faculty Dr. Douglas Opel and bioethics staff member Katherine Lepere, recognizes that anesthesiologists are attempting to accomplish multiple goals when speaking to patients and parents prior to surgery, all in a limited window of time. The team is focused on how anesthesiologists and parents communicate, with the goal of ensuring that parents understand anesthesia information and are satisfied that they have been adequately informed to make decisions.
Having found that informed consent was relatively thorough and well understood in an observational study of communication between anesthesiologists and English-speaking parents, Gentry intends to turn her attention next to the informed consent process with populations for whom English is not their primary language. She is also investigating how anesthesiologists across the country are communicating with families about an FDA safety warning regarding potential neurotoxicity of anesthetic drugs in infants and young children.
“A critical component of providing high quality healthcare to children is anesthesiologists' effective communication with parents about the interventions available and their attendant risks and benefits. Discussions between anesthesiologists and parents are typically last minute and rushed. My goal is to identify strategies that ensure parental comprehension of anesthesia information and to highlight the opportunities for parental input in a child's anesthetic care.”
To understand more about patients’ and families’ experience with the informed consent process for anesthesia in order to be able to make improvements to how and when this information is delivered.
- Pediatric Pilot Award, Center for Clinical and Translational Research
- Bioethics Research Incubator Program, Treuman Katz Center for Pediatric Bioethics