Perceptions of Singaporeans towards informed consent: a cross-sectional survey

Abstract

Introduction: In a patient-centric health system, it is essential to know patients’ views about informed consent. The objective of this study was to understand the perceptions of the local population regarding informed consent. Methods: Spanning across six weeks from January 2016 to March 2016, a cross-sectional survey of adults attending General Surgery outpatient clinics at Tan Tock Seng Hospital was performed. Sociodemographic data, lifestyle and health-related information, perception and purpose of consent forms, and decision-making preferences were studied. Results: 445 adults participated in the survey. Most participants were below 40 years old (n = 265, 60.1%), female (n = 309, 70.1%) and degree holders (n = 196, 44.4%). 56.9% of participants wanted to know every possible risk, while 28.3% wanted to know common and serious risks. On multivariate analysis, age (age 61–74 years: odds ratio [OR] 11.1, 95% confidence interval [CI] 2.2–56.1, p = 0.004; age > 75 years: OR 22.2, 95% CI 1.8–279.1, p = 0.017) was a predictor of not wanting to know any risks. Age also predicted risk of disclosure for death (age 61–74 years: OR 13.4, 95% CI 4.2–42.6, p < 0.001; age > 75 years: OR 32.0, 95% CI 4.5–228.0, p = 0.001). Most participants (48.1%) preferred making shared decisions with doctors, and an important predictor was employment status (OR = 4.8, 95% CI 1.9–12.2, p = 0.001). Conclusion: Sociodemographic factors and educational level influence decision-making, and therefore, the informed consent process should be tailored for each patient.