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| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 4
| Issue : 1 | Page : 17-20 |
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Knowledge and attitude toward informed consent in medical and dental practitioners, of Bhopal City, India
Anshika Khare, Vrinda Saxena, Manish Jain, Vijayta Sharva, Prakash Singh, Ashwini Dayma
Department of Public Health Dentistry, People's Dental Academy, Bhopal, Madhya Pradesh, India
| Date of Web Publication | 3-Jul-2017 |
Correspondence Address:
Anshika Khare
Department of Public Health Dentistry, People's Dental Academy, People's University, Bhopal, Madhya Pradesh
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jdrr.jdrr_32_17
Background: Consent is a lawful right of a patient that makes a decision their involvement in clinical procedures. The meaning of consent is that patient not to be touched or in nevertheless treated without their permission, it deems like an endorsed inquiry for their protection. Concept of consent is an endeavor by which the patient can take part in clinical judgment concerning their treatment and protect each and every patient against any litigation. Thus, knowledge and approach of consent are foremost important due to encroachment in clinical procedures in dental and medical field as well as it is also important for general population. Aim and Objectives: The aim of the study was to appraise the knowledge and attitude toward informed consent in medical and dental practitioners of Bhopal city, India. Materials and Methods: A cross-sectional assessment was carried out among 200 medical and dental practitioners of Bhopal city. A self-administered, close-ended planned questionnaire was used to evaluate their knowledge and attitude regarding informed consent. This questionnaire consists of 10 and 5 questions of knowledge and attitude, respectively. The response format was obtained by a 3-point Likert scale. Statistical analysis was done using SPSS version 20; Chi-square test was used for data analysis. Result: Knowledge and attitude regarding informed consent were uneven amid medical and dental professionals. Although it was slight higher in medical professionals. Conclusion: An unbalanced knowledge of informed consent in medical and dental professionals recommended; a need to conduct assort of awareness programs and workshops regarding informed consent. Thus, this gap of knowledge can fill and an affirmative attitude can develop. Keywords: Dental practitioners, informed consent, medical practitioners
How to cite this article:
Khare A, Saxena V, Jain M, Sharva V, Singh P, Dayma A. Knowledge and attitude toward informed consent in medical and dental practitioners, of Bhopal City, India. J Dent Res Rev 2017;4:17-20 |
How to cite this URL:
Khare A, Saxena V, Jain M, Sharva V, Singh P, Dayma A. Knowledge and attitude toward informed consent in medical and dental practitioners, of Bhopal City, India. J Dent Res Rev [serial online] 2017 [cited 2023 Mar 29];4:17-20. Available from: https://www.jdrr.org/text.asp?2017/4/1/17/209361 |
| Introduction | |  |
The concept of consent in medicine came from ethics and the Hippocratic Oath is one of the ancient forms of medical ethics. The meaning of consent is that patient not to be touched or in nevertheless treated without their permission, it deems like an endorsed inquiry for their protection. Consent is a deliberate concord between doctor and patient, and in health-care sector, it gives moral values to maintain the dignity of profession. Consent is a lawful right of a patient to take part in the clinical judgment concerning their treatment and protect each and every patient against any litigation.
It is an obligatory duty of health-care professionals to help their patient for taking conversant decisions regarding treatment procedure. Thus, knowledge and approach of consent are foremost important due to encroachment in clinical procedures in dental and medical field as well as it is also important for general population.
Consent
Consent is a voluntary acceptance or agreement of what is planned or done by another person.[1] Not taking consent is considered as deficiency in Medical Services under the Section 2 (i) of the Consumer Protection Act.[2] Consent is a fundamental and established principle in the Indian Law. Every person has the right to determine what shall be done to his/her body. Self-defense of the body (under IPC Section 96–102, 104, and 106) provides right to the protection of bodily integrity against invasion by others.[1]
Informed consent
Informed consent is the process by which the treating health-care provider discloses appropriate information to a competent patient so that the patient may make a voluntary choice to accept or refuse treatment.
It originates from the legal and ethical right the patient has to direct what happens to his/her body and from the ethical duty of the physician to involve the patient in his/her health care.[3]
Implied consent
Implied consent refers to when a patient passively cooperates in a process without discussion or formal consent. Implied consent does not need to be documented in the clinical record.
Verbal consent
A verbal consent is where a patient states their consent to a procedure verbally but does not sign any written form. This is adequate for routine treatment such for diagnostic procedures and prophylaxis, provide that full records are documented.[4]
Written consent
A written consent is a guarantee-active and explicit consent, thus offering the highest guarantee to the participants. It is most appropriate not only in studies that contain some level of risk but also in many studies with no risk above those of daily life, when participants disclose personal or sensitive information, when they are exposed to deception or any experimental treatment. Experiments in-depth interviews in particular should consider written consent.[5]
To an unsurpassed of our acquaintance, this was a pioneer attempt to appraise the knowledge and attitude regarding informed consent of medical and dental professionals of Bhopal city to fill their gaps.
| Materials and Methods | | |
A descriptive cross-sectional survey was conducted among medical and dental professionals of Bhopal city (Madhya Pradesh) India in February 2017. In this study, 200 medical and dental professionals were randomly selected from Bhopal city. A predesigned, self-administered close-ended questionnaire was distributed among all the medical and dental professionals to appraise their knowledge and attitude toward informed consent. Three-point Likert scale was used to assess the response.
Inclusion and exclusion criteria
Professional who was practicing in medical and dental more than 5 years was selected for the survey; under- and post-graduates and not practicing since 5 years were excluded.
After the selection of participants, questionnaire was distributed among all the selected medical and dental professionals. Among 200 participants, 150 were filled the questionnaire.
Questionnaires were coded and Excel sheet was created for data entry. The data were analyzed using SPSS version 20 (SPSS Inc., Chicago, IL, USA). Chi-square test was used to compare the frequency of knowledge and attitude between dental and medical professionals. Confidence level and level of significance were fixed at 95% and 5%, respectively.
| Results | | |
[Table 1] reveals the knowledge of informed, verbal, and written consent in medical professionals. The knowledge of informed consent in medical professionals was 100%, 95.7%, and 100%, respectively, while in dental professional was 94.3%, 88.6%, and 97.1%, respectively. | Table 1: Describing the comparison of knowledge regarding informed consent between medical and dental practitioners
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Knowledge of informed consent taken after treatment in medical professionals was 47.1% whereas in dental professionals was 20.0%, and this shows statistically significant difference.
Awareness regarding copy of informed consent given to the patient was statistically significant between medical and dental professionals. In medical professionals, it was 94.3%, while in dental professionals, it was 48.6% (P = 0.001).
[Table 2] reveals the attitude regarding informed consent between medical and dental professionals. | Table 2: Describing the comparison of attitude regarding informed consent between medical and dental practitioners
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Attitude regarding taken signature if the consent is verbal shows that 51.4% medical professionals were never taken signature and 48.6% taken the signature sometimes while 82.9% dental professionals never taken signature and 14.3% taken signature sometimes. This illustrates statistically significant different attitude between medical and dental professionals (P = 0.001).
Attitude regarding to provide a copy of consent, if a patient asked, 84.3% medical professionals never provide a copy, but 10.0% provide it sometimes but when we compare it; in dental professionals, 34.3% never provide a copy of informed consent, but 48.6% provide it sometimes. This demonstrates statistically highly significant difference (P = 0.001).
| Discussion | | |
This study was accomplished among 150 medical and dental professionals of Bhopal city, India, to appraise their knowledge and attitude about informed consent. This study substantiates that all medical and 94.3% dental professionals acknowledged that what an informed consent is. Almost comparable results were established by Farhat et al.[6] and Gupta et al.;[7] they also found that 99% and 97.4% dental professionals know that consent as an integral part of dentistry.
The current study showed that 95.7% of the medical and 88.6% of the dentists agreed that they had sufficient knowledge about verbal consent while Gupta et al. had proven that only 68.6% of the dentists had satisfactory knowledge about verbal consent. According to this study, verbal consent was the favorable method to obtain informed consent. Correspondingly, Farhat et al. were also found that among all the types of consent, verbal consent (84.4%) was found to be the favored method of acquiring consent over its written form.
According to the present study, all medical and 97.1% dental professionals know about written consent.
In this study, merely 47.1% medical and 20.0% dental professionals took patient's consent taken after treatment. This shows significantly disproportionate allocation of a knowledge patient on patient's consent taken after treatment in medical and dental practitioners.
In this study, 94.3% medical and 48.6% dental professionals are aware that one copy of informed consent form should be given to a patient if asked for it. This again explains a divergent knowledge of grounds regarding informed consent in medical and dental professionals.
According to this study, attitude regarding informed consent illustrates that 51.4% medical and 82.9% dental professionals never take signatures even if it is a verbal consent but 48.6% medical and only 14.3% dental professionals had sometimes taken it. When compared attitude regarding informed consent for nonsurgical procedures, 42.9% medical and only 11.4% dental professionals had sometimes taken it.
Thus, attitude regarding informed consent was also contradictory among medical and dental personnel. This study exemplifies a dissimilar knowledge and attitude toward informed consent between medical and dental professionals.
| Conclusion | | |
To the best of our knowledge, this is the first attempt to identify knowledge and attitude toward informed consent in medical and dental professionals. This study concluded that informed consent deemed as an integral part of the doctor and patient rapport. Knowledge and attitude should always in a steadiness; once knowledge gets better, attitude will automatically improve. This study has proven that knowledge regarding informed consent was superior in both medical and dental practitioners, but attitude and practicability are often not as good as needed.
This recommended a need to conduct a variety of awareness programs and workshops regarding the knowledge and viability of informed consent. Thus, these enormous gaps of knowledge regarding informed consent can fill, and constructive attitude can build toward consent.
Acknowledgments
We would be thankful to all the study participants for their kind cooperation throughout the study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Finkbeiner BL, Finkbeiner CA, editors. Legal and ethical issues in the dental business office. In: Practice Management for the Dental Team. 7 th ed. St. Louis: Mosby; 2011. p. 59-77.  |
| 2. | Singh K, Shetty S, Bhat N, Sharda A, Agrawal A, Chaudhary H. Awareness of consumer protection act among doctors in Udaipur city, India. J Dent (Tehran) 2010;7:19-23. |
| 3. | Appelbaum PS. Clinical practice. Assessment of patients' competence to consent to treatment. N Engl J Med 2007;357:1834-40. |
| 4. | Implied and Verbal Consent, ACT-Consent to treatment, Patient safety and Quality Unit. Public Health Services. Available at: www.health.act.gov.au. |
| 5. | Daniel C, Russell KS. Making Sense of the Social World: Methods of Investigation. 3 rd ed. Thousand Oaks, CA: Pine Forge Press; 2010. |
| 6. | Farhat W, Qiam F, Shah SM. Informed consent in dentistry: Perceived importance and limitations in Khyber Pakhtunkhwa. JKCD 2013;3:14-9. |
| 7. | Gupta VV, Bhat N, Asawa K, Tak M, Bapat S, Chaturvedi P. Knowledge and attitude toward informed consent among private dental practitioners in Bathinda city, Punjab, India. Osong Public Health Res Perspect 2015;6:73-8. |
[Table 1], [Table 2]
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