The consent process: enabling or disabling patients’ active participation?

Doherty, C, Stavropoulou, C, Saunders, M and Brown, T (2016) The consent process: enabling or disabling patients’ active participation? Health: an interdisciplinary journal for the social study of health, illness and medicine.

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Abstract

Standards expected by doctors’ regulatory bodies in respect of the process of consent to treatment have arguably sought to restructure the nature of the doctor-patient relationship from one of paternalism to that of shared decision-making. Yet, few studies have explored empirically, from patients’ perspectives, the extent to which the process of consent to treatment enables or disables patients’ participation in medical decision-making. Our paper examines patients’ attitudes towards the consent process, exploring how and why these attitudes influence patients’ active participation in decision-making and considering possible consequent medico-legal issues. Data were collected longitudinally using semi-structured interviews and field observations involving 35 patients and 19 of their caregivers, in an English hospital between February and November 2014. These indicate that generally patients defer to the doctor in respect of treatment decision-making. Although most patients and their caregivers wanted detailed information and discussion, they did not necessarily expect that this would be provided. Further, patients perceived that signing the consent form was an obligatory routine principally to protect doctors from legal action should something go wrong. Our study suggests that patients’ predominantly paternalistic perceptions of the consent process can not only undermine attempts by doctors to involve them in decision-making but, as patients are now considered in law as informed actors, their perceptions of the consent form as not being in their interests could be a self-fulfilling prophecy if signing is undertaken without due consideration to the content.

Item Type:	Article
Divisions :	Faculty of Arts and Social Sciences > Surrey Business School
Authors :	Name Email ORCID Doherty, C Stavropoulou, C Saunders, M Brown, T
Date :	24 January 2016
DOI :	10.1177/1363459315611870
Related URLs :	Publisher
Additional Information :	Paper accepted for publication in Health: an interdisciplinary journal for the social study of health, illness and medicine. Copyright 2016 Sage publications.
Depositing User :	Symplectic Elements
Date Deposited :	30 Oct 2015 11:14
Last Modified :	26 Jul 2016 10:09
URI:	http://epubs.surrey.ac.uk/id/eprint/809092

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