Challenges of Obtaining Informed Consent in Emergency Ward: A Qualitative Study in One Iranian Hospital
Nayyereh Davoudi1, Nahid Dehghan Nayeri2, *, Mohammad Saeed Zokaei3, Nematallah Fazeli4
Identifiers and Pagination:Year: 2017
First Page: 263
Last Page: 276
Publisher Id: TONURSJ-11-263
Article History:Received Date: 28/07/2017
Revision Received Date: 02/11/2017
Acceptance Date: 14/11/2017
Electronic publication date: 29/12/2017
Collection year: 2017
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background and Objective:
Regarding the fact that emergency ward has unique characteristics, whose uniqueness affects informed consent processes by creating specific challenges. Hence, it seems necessary to identify the process and challenges of informed consent in the emergency ward through a qualitative study to understand actual patients’ and health care providers’ experiences, beliefs, values, and feelings about the informed consent in the emergency ward. Through such studies, new insight can be gained on the process of informed consent and its challenges with the hope that the resulting knowledge will enable the promotion of ethical, legal as well as effective health services to the patients in the emergency ward.
In this qualitative study, research field was one of the emergency wards of educational and public hospitals in Iran. Field work and participant observation were carried out for 515 hours from June 2014 to March 2016. Also, conversations and semi-structured interviews based on the observations were conducted. The participants of the study were nurses and physicians working in the emergency ward, as well as patients and their attendants who were involved in the process of obtaining informed consent.
Three main categories were extracted from the data: a sense of frustration; reverse protection; and culture of paternalism in consent process.
Findings of this study can be utilized in correcting the structures and processes of obtaining informed consent together with promotion of patients' ethical and legal care in emergency ward. In this way, the approaches in consent process will be changed from paternalistic approach to patient-centered care which concomitantly protects patient’s autonomy.