Informed Consent Practices in Global Surgery among Plastic Surgery Organizations
Rosaline Zhang, MD, MSTR1 Jonathan Bruhn2 Kishan Thadikonda, MD1 Phuong D. Nguyen, M.D.2 Samuel O. Poore, MD, PhD1
1Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health 2 Division of Plastic Surgery, University of Texas Health Science Center at Houston
Background: Global surgery organizations often serve vulnerable populations but there is limited knowledge on the protocols used to obtain informed consent for procedures and content sharing.
Methods: The Plastic Surgery Foundation Volunteers in Plastic Surgery database was queried for plastic surgery organizations actively involved in global surgery. 79 organizations received email invitations to participate in a survey study regarding their protocols for obtaining consent and content sharing practices.
Results: A total of 17 (21.5%) organizations completed the survey. All have been active for at least 10 years and 88.2% (15/17) organize at least two mission trips annually. 88.2% (15/17) obtained written consent for surgical procedures while 11.8% (2/17) obtained only verbal consent. 58.8% (10/17) reported that their staff or volunteers were primarily responsible for obtaining informed consent, while 41.2% (7/17) primarily relied on local health staff/administrators. With regards to consent for sharing content related to global surgery experiences (i.e. photographs, videos, written narratives), 18.8% (3/16) obtained verbal consent only for content sharing, 56.2% (9/16) obtained a separate written consent, 18.8% (3/16) obtained consent concurrently with the surgical informed consent, and 6.3% (1/16) did not routinely obtain any consent. Organizations shared content via their websites (93.3%, 14/15) Facebook (73.3%, 11/15), Instagram (53.3%, 8/15), blog posts (46.7%, 7/15), peer-reviewed articles (40.0%, 6/15), internal grand rounds (40.0%, 6/15), and Twitter (20.0%, 3/15). All organizations reported using interpreters to obtain informed consent. However, only 37.5% (6/16) utilized formally trained professional interpreters, with others utilizing either volunteers (31.3%, 5/16), local health care workers (18.8%, 3/16), or other community members (6.3%, 1/16).
Conclusion: Practices related to obtaining informed consent for procedures and content sharing vary widely among global surgery organizations. Trained interpreters, essential for ensuring clear and accurate patient communication, are not consistently utilized. Global surgery organizations have a responsibility to safeguard patientsí rights, especially their privacy, when creating and sharing publicly viewable content. The development of standardized protocols and guidelines will ensure that global health organizations, in collaboration with their local partners, properly collect informed consent for procedures and content sharing.
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