Table 3 Clinicians’ considerations on obtaining informed consent for tPA treatment in patients with acute ischemic stroke
Quote | |
|---|---|
Reasons for obtaining informed consent* | |
Obliged to (legally and morally) | “Patient’s autonomy comes first, even if I emphasize the urgency of treatment, the patients have the right to decide if they accept (the risks of) treatment. Because of the urgency of the situation I sometimes doubt patients’ capacity to make a measured decision, but I do not think this is a valid reason to refrain from obtaining informed consent.” Resident 37 |
Risk for (severe) complications | |
Invasive treatment | |
No real cause for delay | |
Reasons for not obtaining informed consent* | |
Standard (and proven) treatment | “It [acute ischemic stroke] is an acute situation, where a proven effective treatment can be administered (thrombolysis). In these cases I think that as a doctor you have to act in the medical interest of the patient, which means that without contra-indications or clear other medical reasons, the best treatment [thrombolysis] must be administered in this situation” Neurologist 19 |
Acute situation (‘Time is brain’) | |
Impaired decision-making capacity | |
Act in the best interest of the patient |