To review psychiatrists' documentation of informed consent and present data on Canadian psychiatrists' attitudes and practices regarding documentation of the informed consent process.
Method:
We surveyed a stratified random sample of psychiatrists practising in Ontario, using a mailed self-report questionnaire.
Results:
The response rate was 72%. Among respondents, 63% routinely documented the consent process, with younger respondents reporting more documentation than older ones. Although most respondents (77%) favoured recording the consent process, only 11% felt signed consent forms were necessary.
Conclusion:
There are differences in the self-reported documentation behaviour of younger and older psychiatrists. Psychiatrists should document the consent process in the clinical record.
GrissoTAppelbaumPS. Assessing competence to consent to treatment. A guide for physicians and other health professionals. New York (NY): Oxford University Press; 1998.
2.
Reibl v Huges. 2 Supreme Court Reports 880 (S. Ct. of Canada1980).
3.
DickensBM. Informed consent. In: DownieJCaulfieldTFloodC, editors. Canadian health law and policy, 2nd ed.Markham (ON): Butterworths; 2002. p129–56.
4.
Hopp v Lepp. 2 Supreme Court Reports 192 (S. Ct. of Canada1980).
5.
SchachterDKleinmanIPrendergastPRemingtonGSchertzerS.The effect of psychopathology on the ability of schizophrenic patients to give informed consent. J Nerv Ment Dis1994;182:360–2.
6.
GrissoTAppelbaumPS. The MacArthur Treatment Competence Study. III. Abilities of patients to consent to psychiatric and medical treatments. Law Hum Behav1995;19:149–74.
7.
AbidiSBhaskaraSM. From chlorpromazine to clozapine—antipsychotic adverse effects and the clinician's dilemma. Can J Psychiatry2003;48:749–55.
8.
Tardive dyskinesia: Summary of a Task Force Report of the American Psychiatric Association. Am J Psychiatry1980;137:1163–72.
9.
KaneJMSmithJM. Tardive dyskinesia: Prevalence and risk factors, 1959 to 1979. Arch Gen Psychiatry1987;39:473–81.
10.
LaugharneJDaviesAArcelusJBoumanWP. Informing patients about tardive dyskinesia: A survey of clinicians' attitudes in three countries. Int J Law Psychiatry2004;27:101–8.
11.
SchachterDKleinmanI.Psychiatrists' attitudes about and informed consent practices for antipsychotics and tardive dyskinesia. Psychiatr Serv2004;55:714–7.
12.
JaffeR.Informed consent: Recall about tardive dyskinesia. Compr Psychiatry1981;22;434–7.
13.
KleinmanISchachterDKoritarE.Informed consent and tardive dyskinesia. Am J Psychiatry1989;146:902–4.
14.
MunetzMRRothLH. Informing patients about tardive dyskinesia. Arch Gen Psychiatry1985;42:866–71.
15.
RobinsonGMeravA.Informed consent: Recall by patients tested postoperatively. Ann Thorac Surg1976;22:209–12.
16.
American Psychiatric Association. Task Force Report 18. Tardive dyskinesia. Washington (DC): American Psychiatric Association; 1979.
17.
SovnerRDiMascioABerkowitzDRandolphP.Tardive dyskinesia and informed consent. Psychosomatics1978;19:172–7.
18.
MunetzMRPetersonGA. Documenting informed consent for treatment with neuroleptics; an alternative to the consent form. Psychiatr Serv1996;47:302–3.
19.
LacroJPSewellDDWarrenKWoodySHarrisMJJesteDP. Improving documentation of consent for neuroleptic therapy. Hosp Comm Psychiatry1994;45:176–8.
20.
SchachterDKleinmanI.Psychiatrists' documentation of informed consent. Can J Psychiatry1998;43:1012–7.
21.
CorteseLJogMMcAuleyTJKottedaVCostaG.Assessing and monitoring antipsychotic-induced movement disorders in hospitalized patients: A cautionary study. Can J Psychiatry2004;49(1):31–6.
22.
BorgielAEMWilliamsJIBassMJDunnEVEvensonMKLamontCT, and others. Quality of care in family practice: Does residency training make a difference?CMAJ1989;140:1035–43.
23.
CrowneDMarloweD.A new scale of social desirability independent of psychopathology. J Consult Psychol1960;24:349–54.
24.
FadenRRLewisCBeckerCFadenAIFreemanJ.Disclosure standards and informed consent. J Health Polit Policy Law1981;6:255–84.
25.
HamannJLangerBLeuchtSBuschRKisslingW.Medical decision making in antipsychotic drug choice for schizophrenia. Am J Psychiatry2004;161:1301–4.
26.
GrissoTAppelbaumPSHill-FotouhiC.The MacCAT-T: A clinical tool to assess patients' capacities to make treatment decisions. Psychiatr Serv1997;48:1415–9.
27.
HammondKWSnowdenMRisseSCAdkinsTGO'BrienJJ. An effective computer-based tardive dyskinesia monitoring system. Am J Med Quality1995;10:133–7.
28.
LuoJHalesREServisHGillM.Clinical computing: Use of personal digital assistants in consultation psychiatry. Psychiatr Serv2002;53:271–9.
29.
BakerJGShanfieldSBSchneeS.Using quality improvement teams to improve documentation in records at a community mental health center. Psychiatr Serv2000;51:239–42.
30.
WisnerKLZarinDAHolmboeESAppelbaumPSGelenbergAJLeonardHL, and others. Risk-benefit decision making for treatment of depression during pregnancy. Am J Psychiatry2000;157:1933–40.
