Patient or physician safety? Physicians' views of informed consent and nurses' roles in an Indonesian setting

Abstract

Informed consent is a reflection of patients' autonomy in health decision-making. The main responsibility lies with the doctor. In practice, the nurses' contributions matter as well. This paper presents a case study that explored physicians' perceptions of the existing informed consent process, their suggestions for improvement and their views on the nurses' roles in this process. A two-phase approach was conducted. First, six physicians with different expertise were interviewed. Second, after attending presentations about informed consent and physician–patient relationship principles, 32 physicians were asked to complete an open-ended questionnaire. Data were analyzed by two independent coders and emerging themes were compared. The results of the questionnaires and the interviews were triangulated. Of 32 physicians attending the presentations, 24 (75%) completed the questionnaire. The results indicate that physicians perceive patients, physicians and the hospital as main factors influencing the process of informed consent. Physicians' misinterpretation of informed consent principles, (mis)perceptions regarding patients and their family, and deficient hospital policy and support challenge the informed consent process. Physicians value nurses' roles, provided nurses have sufficient clinical knowledge, sound comprehension of informed consent principles and effective communication skills.

Keywords::

• Informed consent
• interprofessional collaboration
• nurses
• physicians
• roles
• shared decision-making

Acknowledgements

The authors thank Herkutanto and Sugiharto Tanto for supporting the presentation for doctors, and Mereke Gorsira and Jill Whittingham for the English editing.

Declaration of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper. The principal investigator (APS) was working part time for the hospital management to support the medical committee and the nursing committee in developing a credentialing system. The other researchers had no institutional relationship with the hospital. The hospital hosted the presentation for physicians and provided meals.

Notes

Quotes in this paper were translated into English, following the intention of the original Indonesian quotes as closely as possible.