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G90 Parental and professional views regarding consent in neonatology
  1. V Vasu
  1. Neonatal Medicine, William Harvey Hospital, Ashford, UK

Abstract

Aims Babies admitted to neonatal units often require treatments that are regarded as urgent and important (to a lesser or greater degree and in the eyes of the healthcare professionals). Many of these treatments are provided under the umbrella of implied consent whereby the parent’s/carer’s agreement to admit a baby to the neonatal unit tacitly unlocks consent for a number of other tests and procedures. Though many of these tests and treatments are urgent, they are not necessarily emergency in nature and often there may be time for the professional to discuss potential tests and treatment with the family priorto initiating them. The aim of this study was (i) to determine parental and professionals views on type of consent required for 20 neonatal procedures/ interventions in order to inform current neonatal professional practice (ii) to determine whether there has been a change in professional sentiment since the last UK survey in 2003 (1).

Methods With research ethics approval, the views of 69 professionals and 8 parents of ex neonatal patients were sought using online and telephone survey methodology regarding 20 neonatal procedures/interventions and whether implied consent, explicit verbal consent or explicit written consent should be obtained (2).

Results Agreement, defined as both parent and professional consensus view on type of consent was present in 12/20 (60%) procedures/interventions. Comparison between professional views in 2003 and 2016 demonstrated a change regarding type of consent for 50% of procedures/interventions with a move toward obtaining explicit written consent for central line insertion, lumbar punctures, suprapubic aspiration of urine, genetic testing and blood transfusion. There were no differences noted between the survey data with respect to peripheral intravenous cannulation, intercostal chest drain insertion, endotracheal tube insertion, surfactant administration and the use of nitric oxide with the consensus professional view remaining with implied consent.

Conclusions The data presented indicate agreement between parents and professionals for 60% of procedures/interventions in the survey. There has been a change in professional views regarding consent since the last UK survey in 2003. These data might help inform the development of national guidance for how professionals should obtain consent in neonatology.

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