Awareness, knowledge and attitude towards informed consent among doctors in two different cultures in Asia: a cross-sectional comparative study in Malaysia and Kashmir, India
Introduction: Informed consent is now accepted as the cornerstone of medical practice, with reasonable patient standards typically considered to be appropriate in the developed countries; however it is still challenged in many developing countries. The objective of this descriptive study was...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Singapore Medical Association
2007
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/4200/1/4806a12.pdf http://irep.iium.edu.my/4200/ http://smj.sma.org.sg/smjcurrent.html |
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| Summary: | Introduction: Informed consent is now
accepted as the cornerstone of medical
practice, with reasonable patient standards
typically considered to be appropriate in
the developed countries; however it is still
challenged in many developing countries.
The objective of this descriptive study was
to evaluate the perceptions and practices
among attending medical professionals in
matters relating to informed consent in
selected hospitals.
Methods: A questionnaire-based cross
sec tional survey among doctors in the two
tertiary care hospitals, one in Malaysia and
the other in Kashmir, was performed.
Results: Awareness on informed consent
was universal with “reasonable physician
standard” as the most popular choice. As
compared to doctors in Malaysia, doctors
from Kashmir showed a tendency to
reservedly disclose medical information
(p-value equals 0.051) and withhold it, if it
was deemed potentially harmful (p-value is
less than 0.001) or requested so by relatives
(p-value is less than 0.023). They also
withheld some information from female
patients (p-value is less than 0.001). When
consent was refused despite needing lifesaving
intervention, the majority of both
respondents (73 percent versus 80 percent)
considered intervention without consent to
be justifi ed. Respondents from Malaysia felt
that parents could refuse treatment on their
children’s behalf on the basis of their beliefs
(p-value is less than 0.001).
Conclusion: Despite a very high awareness
of informed consent, the model chosen
refl ected age-old medical paternalism.
Doctors’ opinions are accorded a larger
role in clinical decision-making in Kashmir.
The results emphasise the need for doctors
to change their attitude and acknowledge
the patient’s autonomy, which is the basis
of modern medical ethics, and yet still be
aware of the cultural and religious views of
the local population.
Keywords: clinical decision-making, informed
consent, medical ethics, patient autonomy
Singapore Med J 2007; 48(6):559–565
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