RESUMEN
This study was done to explore the views of patients and their companions concerning endotracheal intubation training on newly deceased patients and the necessity of obtaining their consent in this regard. In this cross-sectional descriptive analytical study, we used a questionnaire to collect data through structured interviews conducted by the researcher on patient discharge day. A convenient sample of over 18 year old patients hospitalized at a teaching hospital were enrolled, and after receiving patient consent, one of each patient's companions was enrolled in the study as well. In this study, 150 of the approached patients agreed to participate (response rate = 85.0%); of those, 92 (61.3%) allowed their companions to be enrolled as well. Eighty-three persons (55.3%) in the patient group and 68 persons (73.9%) in the companion group agreed to have endotracheal intubation training on their own bodies after death. Among these consenting patients and companions, 75.9% (n = 63) and 91.2% (n = 62) believed it was necessary to acquire patient consent for this procedure. Obtaining relatives' consent was thought to be necessary by 69.9% (n = 72) of the patients and 72.1% (n = 49) of the companions, even when there was patient prior consent. Therefore it seems that asking the patient's consent for doing educational procedures on their dead body is crucial.
RESUMEN
This study was conducted to examine adherence to ethical principles during research and the necessity to conduct systematic and continuing review of ongoing research in Iran. All clinical trials approved by the Research Ethics Committee of Tehran University of Medical Sciences (TUMS) ongoing in 2007 (n = 21) were reviewed through receiving principal investigators' (PIs) reports, as well as reviewing patient consent forms. Two questionnaires were sent to PIs, one to collect information about the study and the other to evaluate PIs' perception and awareness about ethical codes of clinical trials. A representative of the TUMS research ethics committee was sent to the research site to fill a checklist by reviewing the obtained informed consent and fill the other checklist by interviewing a sample of participants regarding their perception of their volunteer participation in the clinical trial and receiving adequate information. Only in 66.7% of the surveyed trials the objectives of the trial had been explained in the informed consent, and in 38.6% of the trials it was mentioned in informed consent that participation is voluntary. Among participants, 34.7% (n = 26) were not aware they were enrolled in a research project, 29.3% (n = 22) had not understood the information they had received, 74.7% (n = 56) did not know they could refuse to participate and still receive care from their physician, and 58.7% did not realize they were free to drop out of the study at any time. The results point to the need for continuing review of clinical research, especially clinical trials, and the necessity for thorough assessment of patient consent forms during the process of approval in terms of their contents and their understandability.
RESUMEN
BACKGROUND: This study aims to evaluate the attending surgeons' and residents' attitudes towards error disclosure and factors that can potentially affect these tendencies in major academic hospitals affiliated with Tehran University of Medical Sciences (TUMS). METHODS AND MATERIAL: In a cross-sectional study, self-administered questionnaires were delivered to all attending surgeons and second to fourth year surgical residents of TUMS during October and November 2009. The questionnaire contained two clinical scenarios and questions regarding physicians' attitudes towards disclosing medical error and their actual practice in the case of their last error. Of the 63 distributed questionnaires, 53 (84.1%) were completed and returned. RESULTS: Participants were less likely to disclose minor (39.6%; 21/53) than major (49.1%; 29/53) medical errors. Participants believed that their most important concerns for not disclosing errors were fear of a malpractice lawsuit (71.7%, n=38), losing patients' trust (62.3%, n=33), and emotional reactions of the patients and their relatives (56.6%, n=30). Although most physicians indicated they would disclose errors in minor and major scenarios, only 16.7% (n=8) had disclosed their last medical errors to their patients, two of which had resulted in patients taking legal action. CONCLUSION: There was an obvious gap between surgeons' intentions and actual practices concerning disclosure of medical error. Education in medical error management to professionally support error disclosure might help reduce the gap.