High reading levels needed

Research out of Columbia University has indicated that language used in patient consent forms is too difficult to understand. And if patients cannot understand consent forms, it follows that they also do not fully grasp the treatment recommendations they have consented to.

Of 113 consent forms that evaluated in the research, only 9 met the Grade 8 recommended readability standard. Researches were surprised at the high reading level required to understand the forms. However, rather than suggesting improvements to the wording of forms Nancy E. Kass, of Johns Hopkins Berman Institute of Bioethics, has highlighted the ethical importance of good communication.

“Looking someone in the eye, getting a sense of whether they’re with you, and even asking them to repeat back what they understand is the most likely strategy to achieve a meaningful understanding,” suggested Kass, while also indicating that consent forms should serve as a guiding document for further conversation.

Notwithstanding, Aaron S. Fink, of Taylor Healthcare in Atlanta, indicated that ensuring consent forms are at appropriate reading levels is still one of the many issues that need to be addressed in the healthcare process.

It seems the significance of consent and the patient’s full understanding of their medical situation cannot be underestimated in a patient-centred approach. Indeed, ethical questions around presumed consent (as seen with opt-out organ donation in Nova Scotia) become further complicated if presumptions are misguided.

The lead author of the study in JAMA Oncology, Andrew J Einstein, suggests there is opportunity for medical ethicists and clinicians to work together to ensure consent is clear to patients.

Nic Zumaran writes from Sydney

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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