TY - JOUR
T1 - Informed consent among chronically ill elderly
T2 - Assessing its (in)adequacy and predictors
AU - Hines, Stephen C.
AU - Badzek, Laurie
AU - Moss, Alvin H.
N1 - Funding Information:
Stephen C. Hines (Ph.D., Purdue University) is an assistant professor in the Communication Studies Department at West Virginia University. Laurie Badzek (J. D., West Virginia University; M.S.N., DePaul University) is an assistant professor of Nursing at West Virginia University. Alvin H. Moss (M.D., University of Pennsylvania) is a professor of Medicine and the Director of the Center for Health Ethics and Law at the West Virginia University Health Sciences Center. An earlier version of this essay was presented at the annual meeting of the International Communication Association in May, 1996. Research reported in this essay was funded by a grant from the National Kidney Foundation of Western Pennsylvania. While the authors gratefully acknowledge this support, positions taken in the paper do not necessarily reflect the views of the sponsoring organization. The authors also thank Dave Seibold and two anonymous reviewers for their constructive comments on the paper, and the patients and dialysis unit staff whom we interviewed for their insights and cooperation. Correspondence concerning this article should be addressed to Stephen Hines, Communication Studies Department, P.O. 6293, West Virginia University, Morgantown, WV 26506-6293. Electronic mail may be sent to STHINES@WVNVM.WVNET.EDU.
PY - 1997/8
Y1 - 1997/8
N2 - Physicians are legally and ethically required to obtain informed consent from patients prior to providing medical care. However, the chronically ill elderly may poorly understand the facts that are needed for them to make informed choices, and they also may wish to avoid discussing potentially discouraging information. Interviews of 142 elderly hemodialysis patients were conducted to determine whether informed consent for performing dialysis had been obtained and to explore potential causes of inadequate informed consent. As predicted, most patients lacked information needed to render fully informed consent. However, when we examined potential causes for the very low levels of knowledge reported by patients, we found that patients' education level, cognitive capacity, and willingness to discuss medical contingencies were stronger predictors of informed consent than were the communicative practices of doctors. Neither doctors' willingness to promptly disclose the need for dialysis nor their willingness to discuss forgoing dialysis were related to any of the patient characteristics. Results suggest that obtaining fully informed consent for chronically ill elderly requires both a modification of doctors' communication practices and greater adaptation to the cognitive capacity, education, and communication practices of the patient.
AB - Physicians are legally and ethically required to obtain informed consent from patients prior to providing medical care. However, the chronically ill elderly may poorly understand the facts that are needed for them to make informed choices, and they also may wish to avoid discussing potentially discouraging information. Interviews of 142 elderly hemodialysis patients were conducted to determine whether informed consent for performing dialysis had been obtained and to explore potential causes of inadequate informed consent. As predicted, most patients lacked information needed to render fully informed consent. However, when we examined potential causes for the very low levels of knowledge reported by patients, we found that patients' education level, cognitive capacity, and willingness to discuss medical contingencies were stronger predictors of informed consent than were the communicative practices of doctors. Neither doctors' willingness to promptly disclose the need for dialysis nor their willingness to discuss forgoing dialysis were related to any of the patient characteristics. Results suggest that obtaining fully informed consent for chronically ill elderly requires both a modification of doctors' communication practices and greater adaptation to the cognitive capacity, education, and communication practices of the patient.
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U2 - 10.1080/00909889709365474
DO - 10.1080/00909889709365474
M3 - Article
AN - SCOPUS:0031505674
SN - 0090-9882
VL - 25
SP - 151
EP - 169
JO - Journal of Applied Communication Research
JF - Journal of Applied Communication Research
IS - 3
ER -