Informed Consent for Surgery During COVID-19

2020

Background The coronavirus disease 2019 (COVID-19) pandemic has changed the dynamics of healthcare, and the elective surgical consent process has also evolved. The Royal College of Surgeons of England published guidance on consent during COVID-19. Through this study, we aimed to assess our local consent adherence to these guidelines on the resumption of elective activity after the first wave of COVID-19. Methods This prospective review of consecutive elective surgical consent forms was conducted from 20 July 2020 to 16 August 2020 at the Princess Alexandra Hospital NHS Trust, England. The primary outcome was evidence of COVID-19 risk documentation on the consent forms. Results A total of 116 patients’ consent forms were reviewed. Most patients were American Society of Anaesthesiologists (ASA) grade 2 (n=70; 60.34%). Only 25 consent forms (21.55%) had COVID -19 and its associated risks documented, with registrars being the most compliant (19/46; 41.3%) followed by consultants (6/51; ...

Indian Journal of Surgery, 2020

COVID-19 caused many countries to stop their elective procedures to allow preservation of resources for COVID-19 care. With restriction being gradually lifted, the surgical services have to face the pending burden of elective cases alongside the pandemic. The true impact of the pandemic and the COVID-19 on perioperative outcomes is still being discovered. This demands a COVID-specific consenting process in addition to the routine surgical consent, to ensure that the patients are able to make informed decisions. The first ever COVID-specific checklist for surgical consent 'COVID times-surgical consent checklist' is introduced. This checklist enables the surgeon to ensure that a discussion detailing the impact of COVID-19 on surgical services is made. It also acts as a documentation of the discussions carried out during the consenting process.

Annals of Surgery, 2020

COVID-19 has urgent implications for surgical informed consent. Acknowledging profound unknowns of surgical risk in the COVID era, we advocate for an enhanced informed consent performed by the attending surgeon of record, and offer a five-part discussion guide for explaining the unique risks and benefits of undergoing an operation at this time.

Journal of Surgical Oncology, 2021

Background: Cancer patients configure a risk group for complications or death by COVID-19. For many of them, postponing or replacing their surgical treatments is not recommended. During this pandemic, surgeons must discuss the risks and

Annals of Medicine and Surgery, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Informed consent for surgery: do our current practices conform to the accepted standards? J Coll Physicians Surg Pak. 2014 Oct;24(10):775-7. doi: 10.2014/JCPSP.775777. [PubMed] PMID:25327928, 2014

A qualitative investigation was undertaken to determine and analyse the pattern of existing practices regarding informed consent for surgery at PIMS, Islamabad. Adult postoperative patients who had undergone surgical interventions were randomly selected face-to-face with the help of a team of junior doctors. A questionnaire was employed for data collection and the responses of the patients to the questions regarding various attributes of the consent process were analysed. Overall inadequacy existed in the prevailing practices. There is a need to revisit the consent related practices and make the process more informed and adequate. Instead of taking it as a casual formality, our doctors should regard it as an equally important exercise equivalent to other components of care such as the surgery itself.

Context: The ongoing Covid-19 pandemic and the subsequent nationwide lockdown, has impacted all aspects of society including the medical profession. In hospitals, the focus has mainly shifted to prevention and treatment of Covid-19 infection. Owing to this, all elective surgeries are being postponed and only emergent surgeries are being performed. This has affected the patients differently depending on the progression of disease and development of complications. Aim: The aim of this study is to evaluate the attitude of the patients regarding their planned surgical treatment in view of COVID 19 pandemic. Settings and Design: Hospital based; Cross-sectional; Telephonic survey Methods and Material: A well-structured telephonic scripted questionnaire was administered to all patients who were given an appointment for any elective surgery. Data was collected regarding the status of disease including complications and the patient’s perspective on the method of treatment. Patients who developed complications or underwent emergency surgery or surgery elsewhere were excluded. Statistical analysis used: Collected data was entered in MS Office Excel spreadsheet and analysis was done using SPSS software. Results: The man to women ratio was 2.3:1. The mean age of patients was 41.16 years. A total of 86 patients were included in the study. Almost all (98.8%) were aware that the lockdown and withholding of elective surgeries were directed to prevent the spread of coronavirus infection. Among 34 patients with progressive disease, 88.2% were willing to undergo the surgical procedure and 73.5% were willing to visit hospital within a week or two. Among 46 patients, who were Willing to continue the treatment on wait and watch policy, 45.7% patients wanted to wait for more than 2 months for their treatment, and 93.5% patients were avoiding hospital visit because of infection. Conclusions: Patient’s attitude towards the choice of treatment (wait and watch Vs surgery) mainly depended on the progression of disease. It is critical, during these tough times of Covid-19 pandemic, that risks are weighed against benefits to decide the line of management for patients waiting for elective surgeries.

BJOG: An International Journal of Obstetrics and Gynaecology, 2004

Goda Bulybenko (Independent Scholar)-Il mare diabolicum di Opicino de Canistris: il crocivia tra antichità, medioevo e rinascimento. Session 3-Between West and East: christians and muslims in the Atlantic and Mediterranean world Renato Viana Boy (Universidade Federal da Fronteira Sul)-A circulação do poder imperial de Constantinopla no Mediterrâneo após a chamada "Queda do Império Romano do Ocidente"séculos V e VI Alexander Matveev (St Petersburg State University)-Ibn Khurdadhbeh's Snapshot of the Ninth Century European Long-distance Trade: The Arab Sources' Views on the Sea and Land Trade Routes in Medieval Europe and Beyond. [ZOOM] Alexandre Bento (Instituto de Estudos Medievais-NOVA FCSH)-O contributo das vias marítimas e fluviais para a música do Al-Andalus português. Uma abordagem arqueomusicológica 17h45-Book presentation: Os territórios da Lisboa medieval (Professor Adelaide Millán da Costa) and Global Turns, Local Circles. People, Ideas and Model in flux in Medieval Europe (Professor Hermenegildo Fernandes), followed by a Porto de Honra, offered by the Municipality of Lisbon.

International Journal of Cultural Property, 2022

In this article, we reflect on the current socio-political context of the 1972 World Heritage Convention after 50 years rather than its significant achievements and trials throughout its turbulent history. The United Nations Educational, Scientific and Cultural Organization (UNESCO) has already documented and publicized these formative episodes. Instead, we consider the World Heritage milieu today, embedded as it is within a much broader landscape of non-governmental organizations and civil society preservation initiatives than it was five decades ago. Like other United Nations agencies, UNESCO now faces challenges arising from various types of re-spatialization beyond the nation-state that further impact its effectiveness. Those challenges encompass not only the expansive force of globalization but also regionalization and localization, all of which have given rise to a new diplomacy. We discuss the proliferation of competing international agencies and individual donors, then describe the dilemmas facing World Heritage, including the rise of non-state actors and post-conflict remediation in the Middle East, the limited recognition of Indigenous Peoples and their role in decision making, and the persistent failures to remedy the inequitable position of Africa as a priority region.