Sanjay Saint, MD, MPH; Benjamin A. Lipsky, MD; Susan D. Goold, MD, MHSA, MA
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Saint S, Lipsky BA, Goold SD. Urinary Catheters: A One-Point Restraint?. Ann Intern Med. 2003;138:238-239. doi: 10.7326/0003-4819-138-3-200302040-00027
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Published: Ann Intern Med. 2003;138(3):238-239.
We appreciate the letter by Dr. Munasinghe and colleagues and their contribution to this field (1). We are, however, unclear about what they mean by “informed consent with full disclosure.” If they are recommending that patients receiving nonemergent indwelling urinary catheters should be required to sign a consent form, we disagree. Such a policy is less likely to have the desired effect than it is to serve as a deterrent to doctors' placing or ordering urinary catheters. Whether the deterrent would decrease inappropriate use without compromising appropriate use is a matter for empirical investigation. One could extend Munasinghe and colleagues' argument to intravenous catheters and even to certain medications that can have adverse effects (for example, aminoglycosides and amiodarone), thereby making the practice of medicine even more bureaucratically unwieldy. Furthermore, patients and research participants often view the informed consent form as a formality even when they can understand it (2). We agree with other observers that true consent is a dialogue, not a signature (3).
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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