Informed consent menu

Patients should be offered a "menu" of options regarding what level of discussion takes place prior to cataract surgery, according to Michael Austin and co-workers from two hospitals in South West Wales, UK.

One hundred consecutive patients were asked preliminary questions to determine their risk perception and knowledge of cataract surgery together with the level of information they wanted prior to giving their consent. Those who proceeded were shown a narrated PowerPoint presentation that was designed to both educate and act as a standardized questionnaire. Every patient was asked to rate each component of the presentation for its relevance to their ability to give informed consent.

Of the 100 patients questioned, 95% knew that cataract surgery involves an element of risk, however 32% did not wish to know anything about the risks and would prefer to leave the decisions to their ophthalmologist. Twenty-two percent were only interest in knowing their overall chance of visual improvement. The remaining 46% welcomed discussion about the possible complications.

Of the 25 patients who completed the whole presentation, 18 wanted to know about PC tearing, 17 about endophthalmitis, 16 about dropped lens, retinal detachment and corneal clouding and 15 wanted to know about bleeding, sympathetic ophthalmia and posterior capsular opacification.

The researchers concluded that patients differ quite widely in what level of information they want before giving informed consent so recommend offering a "menu" of choices for the patient to pick from.