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Survey of informed consent for endoscopy
  1. A I THURAISINGAM
  1. Royal Preston Hospital
  2. Sharoe Green Lane North
  3. Fulwood, Preston, PR2 9HT, UK
  4. adrian{at}ivothuraisingam.freeserve.co.uk

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Editor,—Informed consent is an integral part of good medical practice. The recently published Department of Health (DoH) reference guide to consent for examination or treatment lays out the most up to date recommendations for obtaining consent.1 It includes guidance relating to the timing of consent and the provision of sufficient information for valid consent. For gastroenterologists, consent for procedures usually relates to endoscopy, and guidelines for this have also been produced by the British Society of Gastroenterology.2 It is not clear how well endoscopists and endoscopy units perform in relation to these guidelines, and the guidelines themselves acknowledge the practical difficulty of achieving some of the standards. To attempt to assess current practice, a questionnaire was used to obtain information from endoscopy units.

A standard anonymous questionnaire was sent to the ward manager of each of the endoscopy units in the North West region asking about current practice in the unit with regard to consent for outpatient endoscopy. An accompanying letter explained the rationale for the questionnaire. Both district general and teaching hospitals were included. Seventeen of 20 units (85%) responded and each of the questionnaires returned was fully completed. Table 1 shows the results.

Table 1

Results of questionnaire

Although this simple questionnaire survey only examined one postgraduate region and did not cover a large number of units, there was a high response rate and so the results are representative of current practice within this region and probably reflect practice in the UK as a whole. It clearly demonstrates widespread variation in practice, both between individual units and to a lesser extent between individual doctors working at the same units. Present consent procedures appear to fall short of the ideal set out by the DoH guide and the GMC, particularly with regard to information about procedural risk, involvement of trainees in service provision, and allowing patients sufficient time to make informed decisions.1 3The DoH guide recommends that consent should be sought well in advance and that information should be given about “significant” risks. Arguably the amount of information given about such matters as procedural risk may vary on a patient by patient basis. In a busy working environment, extra time spent explaining procedures may not appear productive but in the longer term will safeguard against complaints and even litigation.

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