Informed consent: the physicians' perspective

Abstract

Using the current controversy in breast cancer treatment as a model, this paper reports on physicians' attitudes and behavior in the use of informed consent. Findings are based on a survey of 170 oncologists from eight countries and representing three medical specialties. Physician responses indicate that they regarded informed consent as an intrusion into the doctor-patient relationship. Problems identified by the physicians included: decreasingly effective doctor-patient communication; less personalized relationships with patients and curtailed freedom with regard to disclosure procedures. They also viewed the informed consent regulation as having a negative impact on their patient care. The constraints of obtaining informed consent reduced physicians' willingness to participate in scientific experiments. The consent form was seen to highlight their dual role as care-giver and scientific investigator, making them uncomfortable in dealing with patients. These findings demonstrate the ways in which legal restrictions associated with the introduction of new technologies critically affect the practice of medicine.

KIE: Oncologists, representative of those who place patients in breast cancer trials, were surveyed to ascertain their attitudes and practices regarding informed consent. The responses of the 170 physicians from eight countries and three medical specialties revealed that the necessity of obtaining informed consent reduced their willingness to participate in clinical trials, intruded into the physician patient relationship, and had a negative effect on patient care. Problems identified by the oncologists included: less effective communication and flexibility in disclosure; decreased patient confidence in the physician, leading to decreased patient compliance; and conflict of interest between the physician's roles as care-giver and scientific investigator.