WRITTEN INFORMED CONSENT. (WIC)
Title.
Written informed consent in the Community
of Madrid.
Background.
Doctor-patient relations are changing these
days, influencing doctor-patient communication and the way
clinical decisions concerning the patient are made. In this
context, written informed consent has arisen.
Objectives.
- To describe how the doctor and
how the patient perceive the doctor-patient relationship.
- To describe how the doctor and
the patient perceive doctor-patient communication.
- To describe how the doctor and
the patient perceive the process of clinical decision-making.
- To describe how the doctor and
the patient perceive WIC.
Methodology.
It was descriptive, cross-sectional study
with qualitative and quantitative methodology applied to doctors
and patients.
Qualitative Phase with physicians: the aim of this phase
was to identify the variables implied in the assessment
that the doctors make of WIC. To do this, discussion groups
and semi-structured interviews with doctors from public
and private hospitals in the Autonomous Community of Madrid
were organized.
Quantitative Phase with physicians: With the information
obtained from the doctors in the qualitative phase, a
questionnaire was prepared for the quantitative phase.
This phase had the aim of getting to know how doctors
from the public and private hospitals of the Autonomous
Community of Madrid assess the WIC process.
Qualitative phase with patients: Discussion groups and
semi-structured interviews were organized with patients.
The patients' discourse was analyzed.
Participants, along with the Foundation's
Science Department
Unit of Research on Health Services of the
Carlos III Institute of the Spanish Ministry of Health and
Consumer Protection, University Center of Public Health.
Financed by the Fund for Health Research of the Ministry
of Health and Consumer Services.
Status.
The results already achieved have been presented
in various meetings of the International Society of Technology
Assessment in Health Care:
16th Annual Meeting of the International Society of Technology
Assessment in Health Care. La Haya, Holanda, 18-21//06/2000.
Proceedings of the International Society of Technology
Assessment in Health Care (ISTAHC) 15th Annual Meeting.
Edinburgh, UK, 20-23 June 1999.
14th Annual Meeting. ISTAHC. Ottawa, Canada, 1998.
13th ISTAHC Annual Meeting. Barcelona, 1997.
In summary, they show that physicians identify WIC as a legal
form that contains detailed information about the risks of
the procedures. They are of the opinion that WIC does not
serve as an instrument of doctor-patient communication and
could even be harmful for patients and for the doctor-patient
relationship. The doctors recognized that WIC is essentially
a defensive tool which serves the physicians' needs more than
the patients'. They question its effectiveness and in practice
they reduce it to a mere bureaucratic requisite that does
not help to inform patients or to assist their participation
in decision-making.
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