Hershey, Pa. --- A survey of hospital consent forms were found to be too complicated for many patients to understand, and not enough information was provided to patients about the planned procedure.
"You need at least a high school education to understand most of the forms. For about 25 percent of the forms you would need several years of college to properly comprehend them, " says Kenneth Hopper, M.D., professor of radiology at Penn State's College of Medicine and a physician with the Penn State Geisinger Health System. "Additionally with 9 percent of the forms, you need education beyond college to fully understand the form.
"When people are sick and under stress, they tend to remember less than they normally would when healthy," he adds. "These forms are to help educate them about the procedure they are going to undergo along with the risks and complications of the procedure. We found many of these forms to be needlessly complex."
Hopper and his colleagues evaluated 616 consent forms from hospitals around the country. The forms were judged on a number of different criteria including: general and specific information on the procedure, benefits and risks, alternatives and possible complications.
Their article, "The Readability Of Currently Used Surgical/Procedure Consent Forms In The United States," is published in the May issue of the journal Surgery.
"The forms were not just too complicated, but many simply did not provide enough specific information for patients. The best kind of form did require some work on part of the physician to complete. Those forms listed the condition, treatment alternatives, complications and other for each individual patient," adds Hopper.
While nearly 93 percent of the forms stated a general description of the procedure, only 6 percent listed the specific benefits of the procedure. Approximately 5 percent listed any specific alternatives to the planned procedure. In addition, just over 30 percent listed specific risks and only 21 percent listed risks of not having the procedure at all.
Hopper also says the forms should be seen as an educational tool to compliment the verbal consultation from the physician.
"Consent forms for the use of anesthesia and blood transfusion should be separate from general consent forms. These two things have their own set of complications," says the Penn State researcher.
While 87 percent of the forms asked for permission for anesthesia, only 47 percent of those stated that there were additional risks from the anesthesia itself and only 14 percent discussed the risks of anesthesia. Only 28 percent of the forms requested permission to transfuse blood should it become necessary.
Hopper says that all hospitals should routinely reevaluate their consent forms that are used. He believes the use of lay people to evaluate these forms for understanding and comprehension could be helpful for many facilities. It would take only a small amount of time and very little cost to make significant changes with consent forms. Patients and families would be better served with specific forms tailored to discuss their individual procedures, he notes.