الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Informed consent is a legal doctrine in medical practice, derived from the ethical principle of respect for autonomy, every competent adult has the right to decide whether to consent or refuse any medical treatment, even if such refusal could lead to death. However, this right to respect for autonomy could be overridden under certain conditions such as where there is temporary or permanent mental incapacity due to unconsciousness, infancy, or severe mental retardation.
Informed consent legitimizes in a legal sense the physician’s interference with a patient’s fundamental rights and freedoms, therefore a physician, who treats a patient without consent or exceeds the consent given by a patient, may be guilty of infringing the patient’s right to bodily integrity and bodily well being.
The increased complexity of the power of medical science and technology has increased the patient’s vulnerability, and physicians might sometimes fail to respect human rights to justify some sort of ill-conceived experiment or medical practice.
This is a descriptive cross sectional study, carried out to assess knowledge, attitude and practice of physicians working in SCU hospital in obtaining patients’ informed consent for medical procedures, and to design an informed consent form that contained all elements of correct IC documentation.
This assessment was done using English, self-administered questionnaire, which included physicians’ characteristics (not including the name) e.g. age, sex, scientific degree, and the duration of clinical practice. It also included knowledge, attitude and practice of physicians of obtaining patients’ informed consent for medical procedures.
The practice was also assessed by a predesigned checklist that assessed the completion of elements of written informed consent documentation in a sample of IC documents present in SCU hospital.
The study included 202 physicians working in the different departments of Suez Canal University hospital and 115 written informed consent documents from the files of patients admitted in SCU hospital.
In the present study, participating physicians’ age ranged from less than 30 years to 60 years, 44% of them had master degree as a qualification. Fifty percent of them had experience of 5 years or less.
The study demonstrated that there is a deficiency in the participating physicians’ knowledge of the ethical issues of informed consent, as only 15% of them showed good knowledge and 48% of them showed accepted knowledge, 70.3% of them knew that obtaining IC is mandatory before any medical procedure; only 32.2% of them knew that implied consent is the consent used for general medical examination. Regarding the legal age of consent, only 32.2% of them were able to correctly identify the age of consent to medical procedures in Egypt, As to consent in emergency, only 54% of the physicians knew that the competent patient has the right to refuse life saving treatment.
Concerning the attitude of the participating physicians toward the ethical issues of IC, only 9% of them showed proper attitude, while 41% showed accepted attitude and the majority of them (50%) demonstrated improper attitude. Regarding IC and the physician patient relationship, 69.8% of the participating physicians agreed that obtaining IC improves the physician patient relationship and also improves the compliance of patients to treatment.
As to the information that should be disclosed with the patient in order to obtain a valid IC, 60.8% of the participating physicians agreed that the purpose of the treatment/intervention should be explained to the patient, 62.4% stated that additional information about the general risk of the suggested treatment is need to be shared with the patient while only 47% agreed that the specific risks also need to be disclosed, and 64.9% of the participating physicians felt that information about other treatment options should also be discussed with the patient.
Regarding the practice of the participating physicians in obtaining patients’ informed consent for medical procedures, only 11% of them showed good practice, 37% of them showed fair practice and 52% of them demonstrated poor practice.
the study demonstrated that 83% of the study group stated that they explain the procedure that will be done to the patient, 73% stated that they also explain to the patient the general and specific risks; while 71% discuss other treatment options with their patients and 81% stated that they inform the patient about possible consequences if he/she refuses treatment.
Regarding respecting the wishes of the patients, only 36% of participating physicians stated that they respect the wish of the patient who refuses life saving treatment. Only 52% of the study group routinely assesses the competence of their patients to consent to treatment and 32% stated that they actually give a copy of the written IC form to their patients.
As for the elements of informed consent documentation, only 39% of the examined documents contained the purpose of the procedure (why the procedure is done), only 48% of the examined documents contained the risks of the suggested intervention.
The study also revealed that only 22% of the examined documents contained information about alternative treatments, their risks and benefits; while 65% contained information about the risks of not receiving treatment, 39% contained a statement indicating that the procedure was explained to the patient or his/her legal guardian, and only 48% contained the name and signature of the medical personnel who explained the procedure to the patient.
Regarding the relationship between physicians’ characteristic data and their knowledge, attitude and practice of obtaining patients’ informed consent for medical procedures, the present study showed the presence of a significant relationship between the participating physicians’ knowledge of ethical issues of informed consent and their age, scientific degree and duration of clinical practice.
Also a significant relationship was found between the participating physicians’ attitude of ethical issues of informed consent and their age, gender, scientific degree and duration of clinical practice
Concerning the practice of the participating physicians in obtaining IC, a significant relationship was found in this study between their practice and their age and scientific degree.
from the present study, its’ concluded that there were inadequate knowledge, attitude and some defects in the practice of participating physicians regarding obtaining patients’ informed consent for medical procedures and a new informed consent form has been designed to help the physicians in the documentation process (Appendix III)