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September 2017 Vol. 5 No.9

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Al azmi SF
Al Jafar AM

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Merit Research Journal of Medicine and Medical Sciences (ISSN: 2354-323X) Vol. 5(9) pp. 432-439, September, 2017 

Copyright © 2017 Merit Research Journals

Original Research Article

Differences in patientsí perceptions and views towards clinical informed consent in public and private hospitals in the state of Kuwait, 2017


Saadoun Faris Al azmi1*, Bashair Abdullah Almutairi1, Haya M Alkhatlan1 and Ahmad Mousa Al Jafar2


1Department of Medical Records, College of Health Sciences, Public Authority for Applied Education and Training (PAAET), Kuwait.
2Department of Surgery, Adan Hospital, Ministry of Health, Kuwait.

*Corresponding Authorís E-mail: drsaadoun@yahoo.com

Accepted September 20, 2017




Patientís autonomy is an imperative issue in the health service area. It is a known fact that patientís awareness and understanding of legal and ethical issues related to the consent process is often limited. Adequate information before a surgical procedure is fundamental to give informed consent. Information should include a description of the benefits, risks, and complications of the intended procedure as well as alternative treatment options. The aim of this study is to compare patients in public and private hospitals of Kuwait as regards their understanding of legal implications, and views about the scope, value and function of consent form during the clinical practice. A comparative descriptive cross-sectional survey was conducted in 6 public and 2 private hospitals from January to June 2016 in the state of Kuwait. A total of 910 patients aged 18 years old and above admitted to the surgery departments in the selected hospitals were invited. Structured self-administered questionnaires were distributed to the patients hospitalized in the selected departments of Kuwaiti hospitals. The questionnaire was pilot-tested prior to being finalized. Statistical analysis was done using SPSS version 21. Confidence interval was 95% and P value <0.05 was regarded as significant. 805 of patients were included (response rate 88.5%). Patients in public hospitals were 584, 72.5% while those in private hospitals were 221, 27.5%. Significantly higher proportion of patients in private hospitals were in the view that signing the consent form is a legal requirement (88.7%). Significantly more private sector patients agreed that signing the consent form means that all exactly are present in the consent form (91.0%), and the doctor cannot do anything different from what was on the form unless it is life-saving (82.4%). More patients in private sector hospitals agreed about the statements that the consent form made it clear what was going to happen (79.6%) and the consent form gave the doctors control over what happened (72.9%). There were no statistical significant differences observed between patients in the two disciplines as regards their responses to the statements the consent form is important (p = 0.167), the consent form made the patient aware of the risks of the operation (p = 0.520), the consent form made the patient wishes known (p = 0.393), the consent form prevents mix ups during the operation (p = 0.470), the consent form was just another piece of paper (p = 0.361), The patient just signed the consent form so he/she could have the operation (p = 0.053) and signing the consent form was mainly to protect the hospital (p = 0.049). Patients in public hospitals had limited understanding of the legal standing of written consent. Many patients seem to have limited awareness of the legal implications of signing or not signing consent forms, and they do not recognize written consent as primarily serving their interests. Current consent procedures seem inadequate as a means for the expression of autonomous choice, and their ethical standing and credibility can be called into question. Informed consent, is time and time again unheeded due to lack of robust system of monitoring and penalties by public hospital authorities. Sincere attempts need to be made at legalizing the value and processes of medical ethics and public health programs should aim at making the patients in public hospitals aware of their legal rights to informed consent.

Keywords: Medical examination; Discretion; Hospitals; Medical ethics






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