GASTROENTEROLOGY ARTICLE OF THE WEEK
September 27, 2007
ASGE Guidelines. Informed Consent for GI Endoscopy. Gastrointest Endosc 2007;66:213-218.
1. The informed consent process should include a discussion of the following items with the patient
a. The use of conscious sedation and possible complications associated with it.
b. The possibility that a permanent colostomy could be a potential complication from a diagnostic colonoscopy
c. Virtual colonoscopy as an alternative to complete colonoscopy for screening
d. Possible adverse outcomes if the procedure is refused should not be discussed as this is a form of coercion
e. The possibility that a cancer or pre-malignant polyp may be missed on endoscopy
True or False
2. When obtaining informed consent, the physician should inform the patients of alternative procedures that could achieve similar, inferior or superior results.
3. Videotaping or recording the inform consent process is the best way to assure that there is no litigation later related to the informed consent process.
4. Brochures, educational material and videos can be adequate substitutes for informed consent, the physician simply needs to solicit a signature after the patient reviews these documents
5. Disputes about the quality of the consent process is a frequent cause in many ERCP-related lawsuits.
6. When obtaining a consent for screening colonoscopy, patients must be informed that having a normal colonoscopy does not guarantee that they do not have or will not get colon cancer
7. Consents cannot be obtained within 10 minutes prior to sedation with midazolam and meperidine as the patient may not remember the consent process
8. The consent process is less important in screening procedures when the patient is healthy and less likely to have complications
9. If a patient requests not to undergo informed consent for fear of learning about possible complications, the procedure cannot be performed
10. In open access endoscopy units, the consent for the procedure should be obtained by the physician ordering the procedure