Understanding patient and surgeon attitudes towards informed consent for sensitive intraoperative exams in colorectal surgery.

BACKGROUND

There is limited understanding of how consent is obtained for digital rectal (DRE) and intraoperative pelvic exams (IPE) in colorectal surgery.

METHODS

Two-pronged survey of colorectal patients and surgeons. Participants self-rated their agreement with various statements regarding consent for surgery, DRE, and IPE.

RESULTS

Out of 90 patients, 77 ​% agreed that surgeons may perform additional procedures other than those explicitly consented to preoperatively. 89 ​% agreed that DRE was implicit in the consent but 65 ​% preferred for it to have been explicitly discussed preoperatively. 75 ​% of patients agreed that IPE was implicit in the consent, but 58 ​% preferred for it to have been discussed preoperatively. Out 49 surgeons, 74 ​% routinely perform maneuvers such as IPE or instrumentation of the vagina when performing stapled anastomoses; only 7 ​% discuss this when obtaining surgical consent.

CONCLUSIONS

Consent discussions should explicitly include sensitive intraoperative exams to prevent erosion of patient autonomy and trust.