Perception Gaps in Informed Consent: Insights from Patients and Surgeons

Open Access

Abstract

Background: Informed consent is essential for patient autonomy in medical practice, but many patients—especially in low-resource settings—have limited understanding and often view it as a legal formality. Factors such as low education, language barriers, and lack of opportunity to ask questions reduce comprehension. This study evaluates patients’ understanding and perceptions of informed consent in surgical care in Bangladesh. Methods & Materials: A cross-sectional study was conducted at Ibrahim Medical College and BIRDEM General Hospital, Dhaka (July–December 2025) among 50 elective surgery patients and 25 surgeons. Data were collected via semi-structured questionnaires on patient understanding and surgeons’ consent practices. Analysis was performed in SPSS v26 using descriptive statistics and Chi-square/Fisher’s Exact tests (p<0.05). Ethical approval and written informed consent were obtained from all participants. Results: Among 75 participants (50 patients, 25 surgeons), most patients were 30–49 years (48.0%), male (56.0%), and had secondary or below education (64.0%), while most surgeons had >5 years’ experience (72.0%). Patients were mostly informed about their procedure (86.0%) but fewer understood risks (48.0%), alternatives (38.0%), had opportunity to ask questions (46.0%). Surgeons largely explained procedures (92.0%) and viewed consent as ethical (72.0%) but discussed risks (64.0%) or alternatives (40.0%) less frequently. Poor patient understanding was linked to lower education (68.8%) and lack of opportunity to ask questions (81.5%), while age and sex were not significant. Conclusion: Surgeons saw consent as routine, though is ethical and legal obligation. The patients’ understanding was low, especially regarding risks and alternatives, highlighting the need for clearer, patient-centered practices.