Surgical informed consent in children: a systematic review

Pranit N Chotai; Richard Nollan; Eunice Y Huang; Ankush Gosain

doi:10.1016/j.jss.2017.02.047

Surgical informed consent in children: a systematic review

J Surg Res. 2017 Jun 1:213:191-198. doi: 10.1016/j.jss.2017.02.047. Epub 2017 Mar 3.

Authors

Pranit N Chotai¹, Richard Nollan², Eunice Y Huang³, Ankush Gosain⁴

Affiliations

¹ Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Sciences Center, Memphis, Tennessee.
² Preston Smith Library of the Health Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas.
³ Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Sciences Center, Memphis, Tennessee; Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee.
⁴ Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Sciences Center, Memphis, Tennessee; Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee. Electronic address: agosain@uthsc.edu.

PMID: 28601314
DOI: 10.1016/j.jss.2017.02.047

Abstract

Background: The purpose of the article was 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 articles concerning any aspect of the surgical informed consent for children undergoing an invasive procedure. Articles analyzing informed consent in research studies, non-English-language articles, review articles, case reports and/or series, letters-commentaries, and dentistry and/or nursing-related articles were excluded. Articles meeting inclusion criteria were analyzed to identify common themes related to the process of informed consent.

Results: One hundred seventy-eight articles were identified on primary search, after removing duplicates and screening titles for relevance, 83 abstracts were reviewed. Thirty-two additional abstracts were identified by secondary search. Twelve of 115 articles met inclusion criteria. Analysis identified five different study themes. Information delivered during consent (Content) was studied in five articles (42%), three (25%) studied the mechanics or delivery of the information (Delivery), three (25%) studied parent participation and discussion (Interchange), six articles (50%) discussed surgeons' perceptions or the parents' ability to understand or recall the information (Comprehension), and five articles (42%) 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.

Keywords: Communication; Consent; Decisional conflict; Informed consent; Parental; Patient centered; Pediatric; Shared decision-making; Surgery; Surrogate.

Publication types

Review
Systematic Review

MeSH terms

Attitude of Health Personnel
Child
Decision Making
Humans
Parental Consent / ethics*
Parental Consent / psychology
Parents / psychology
Professional-Family Relations / ethics
Surgeons / ethics
Surgeons / psychology
Surgical Procedures, Operative / ethics*