Acute Pain and Narcotic Use Does Not Impair the Ability to Provide Informed Consent: Evaluation of a Competency Assessment Tool in the Acute Pain Patient

Lucha Jr., Paul A.; Kropcho, Luisa; Schneider, James J.; Francis, Michael
February 2006
American Surgeon;Feb2006, Vol. 72 Issue 2, p154
Academic Journal
Patients evaluated in acute pain will often have narcotics withheld until after the patient has been evaluated by a surgeon and has given informed consent. Concern that the patient would have impaired judgment due to narcotic effects often prevents the administration of timely pain relief. The Hopkins Competency Assessment Tool (HCAT) is a validated instrument for both psychiatric and medical patients; it has not been validated to evaluate drug effects on judgment. Thirty consecutive patients agreed to participate in the trial over a 12-month period. The HCAT was administered prior to the planned major elective procedure and repeated on each postoperative day up to and including postoperative day 5. Narcotic use (as morphine equivalents), HCAT scores, demographic data, and surgical procedures were recorded. The average age of our patients was 53 years. Twenty-seven patients passed the initial HCAT, and one patient failed subsequent exams. No correlation was seen between HCAT score and narcotic dose. Narcotic administration sufficient for pain control does not impair the ability to provide informed consent. The only patient who failed the HCAT after an initial passing score was somnolent on the narcotic dose.


Related Articles

  • Waiver of Informed Consent, Cultural Sensitivity, and the Problem of Unjust Families and Traditions. Insoo Hyun // Hastings Center Report;Sep/Oct2002, Vol. 32 Issue 5, p14 

    Explains authenticity conditions regarding a patient's waiver of informed consent. Analysis of general conditions under which a patient's waiver of informed consent would be non-autonomous and ethically problematic; Importance of authentic values in personal autonomy; Problems of unjust...

  • A duty to disclose. Sfikas, Peter M. // Journal of the American Dental Association (JADA);Oct2003, Vol. 134 Issue 10, p1329 

    Discusses the historical development of informed consent law in the U.S. Consideration of issues in securing informed consent from patients before beginning treatment; Details on the legal requirement for health care providers to obtain informed consent from patients; Standard for information...

  • consent.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p512 

    A definition of the term "consent," which refers to the decision of a patient to allow a person to perform an act, is presented.

  • Informed Patient Decisions Worksheet.  // Clinical Trials Administrator;Aug2008, Vol. 6 Issue 8, special section p1 

    The article presents the Informed Patient Decisions Worksheet.

  • Informed consent in chronic schizophrenia. Sutherby, K.; Szmijkler, G.; Halpern, A.; Szmukler, G // British Journal of Psychiatry;Mar68, Vol. 168, p381 

    A letter to the editor is presented in response to an article in the 1995 issue which emphasizes on the complexity involved in judments.

  • Talking to Patients. Kaebnick, Gregory E. // Hastings Center Report;Sep/Oct2002, Vol. 32 Issue 5, p3 

    Introduces a series of articles on informed consent given by patients to their doctors.

  • Avoiding Surprises. Gert, Heather J. // Hastings Center Report;Sep/Oct2002, Vol. 32 Issue 5, p23 

    Proposes a model for the obligation of physicians in informing their patients about their medical condition. Information on the legal aspect of informed consent; Importance of informing patients about their condition; Features of the informed consent model.

  • Truth Telling and Advance Planning at the End of Life: Problems with Autonomy in a Multicultural World. Candib, Lucy M. // Families, Systems & Health: The Journal of Collaborative Family ;Fall2002, Vol. 20 Issue 3, p213 

    Focuses on the impact of biomedical culture's approach on information disclosure to patients diagnosed with cancer in the U.S. Advantages and disadvantages of patient disclosure; Details on cross-cultural issues at the end of life; Information on the preference of families in not disclosing...

  • Namibian Women Sue Government over Forced Sterilization. Pyarali, Fahim // Penn Bioethics Journal;Fall2010, Vol. 6 Issue 2, p4 

    The article reports on the Namibian women with HIV who sued the government of Namibia due to their forced sterilization without informed consent.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics