Preoperative consent for patients with limited English proficiency Journal Article


Authors: Patel, D. N.; Wakeam, E.; Genoff, M.; Mujawar, I.; Ashley, S. W.; Diamond, L. C.
Article Title: Preoperative consent for patients with limited English proficiency
Abstract: Background: Informed consent is important for limited English proficient (LEP) patients undergoing surgery, as many surgical procedures are complicated, making patient comprehension difficult even without language barriers. The study objectives were to (1) understand surgeons’ preoperative consenting process with LEP patients, (2) examine how surgeons self assess their non-English language proficiency levels using a standardized scale, and (3) identify the relationship between self assessed non-English language proficiency and surgeons’ self-reported use of interpreters during preoperative informed consent. Materials and methods: A thirty-two item survey assessing surgeons’ reported preoperative informed consent process, with questions related to demographics, level of medical training, non-English language skills and their clinical use, language learning experiences, and hypothetical scenarios with LEP patients. Results: Surgeons who were not fluent in non-English languages reported they often used those limited skills to obtain informed consent from their LEP patients. Many surgeons reported relying on bilingual hospital staff members, family members, and/or minors to serve as ad-hoc interpreters when obtaining informed consent. If a professional interpreter was not available in a timely manner, surgeons more frequently reported using ad-hoc interpreters or their own nonfluent language skills. Surgeons reported deferring to patient and family preferences when deciding whether to use professional interpreters and applied different thresholds for different clinical scenarios when deciding whether to use professional interpreters. Conclusions: Surgeons reported relying on their own non-English language skills, bilingual staff, and family and friends of patients to obtain informed consent from LEP patients, suggesting that further understanding of barriers to professional interpreter use is needed. © 2016 Elsevier Inc.
Keywords: adult; aged; middle aged; preoperative care; clinical practice; self report; doctor patient relation; surgeon; physician-patient relations; informed consent; language; health care surveys; massachusetts; surgeons; health care survey; communication barriers; communication disorder; translating; procedures; health disparities; language barriers; multilingualism; humans; human; male; female; statistics and numerical data; practice patterns, physicians'; physician–patient communication; translating (language)
Journal Title: Journal of Surgical Research
Volume: 200
Issue: 2
ISSN: 0022-4804
Publisher: Academic Press Inc., Elsevier Science  
Date Published: 2016-02-01
Start Page: 514
End Page: 522
Language: English
DOI: 10.1016/j.jss.2015.09.033
PUBMED: 26541685
PROVIDER: scopus
PMCID: PMC4691361
DOI/URL:
Notes: Article -- Export Date: 1 November 2018 -- Source: Scopus
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MSK Authors
  1. Lisa Cari Diamond
    25 Diamond
  2. Margaux Christine Genoff
    13 Genoff