Practice of informed consent in Guangdong, China: a qualitative study from the perspective of in-hospital patients

Abstract

OBJECTIVE: This study aimed to investigate the practice of informed consent in China from the perspective of patients. DESIGN: A qualitative study using in-depth interviews with in-hospital patients focusing on personal experience with informed consent. SETTING: Guangdong Province, China. PARTICIPANTS: 71 in-hospital patients in rehabilitation after surgical operations were included. RESULTS: Medical information is not actively conveyed by doctors nor effectively received by patients. Without complete and understandable information, patients are unable to make an autonomous clinical decision but must sign an informed consent form following the doctor's medical arrangement. Three barriers to accessing medical information by patients were identified: (1) medical information received by patients was insufficient to support their decision-making, (2) patients lacked medical knowledge to understand the perceptions of doctors and (3) patient-doctor interactions were insufficient in clinical settings. CONCLUSIONS: Informed consent is implemented as an administrative procedure at the hospital level in China. However, it has not been embedded in doctors' clinical practices because, from the perspective of patients, doctors do not fulfil the obligation of medical information provision. As a result, the informed part of informed consent was neglected by individual doctors in China. Reforming medical education, monitoring the process of informed consent in clinical settings and redesigning medical institutional arrangements are pathways to restoring the practice of informed consent and patient-centred models in China.