BACKGROUND There is little dispute that the ideal moral standard for surgical informed consent calls for surgeons to carry out a disclosure dialogue with patients before they sign the informed consent form. This narrative study is the first to link patient experiences regarding the disclosure dialogue with patient-surgeon trust, central to effective recuperation and higher adherence. METHODS Informants were 12 Israelis (6 men and 6 women), aged 29-81, who underwent life-saving surgeries. A snowball sampling was used to locate participants in their initial recovery process upon discharge. RESULTS Our empirical evidence indicates an infringement of patients' right to receive an adequate disclosure dialogue that respects their autonomy. More than half of the participants signed the informed consent form with no disclosure dialogue, and thus felt anxious, deceived and lost their trust in surgeons. Surgeons nullified the meaning of informed consent rather than promoted participants' moral agency and dignity. DISCUSSION Similarity among jarring experiences of participants led us to contend that the conduct of nullifying surgical informed consent does not stem solely from constraints of time and resources, but may reflect an underlying paradox preserving this conduct and leading to objectification of patients and persisting in paternalism. We propose a multi-phase data-driven model for informed consent that attends to patients needs and facilitates patient trust in surgeons. CONCLUSIONS Patient experiences attest to the infringement of a patient's right to respect for autonomy. In order to meet the prima facie right of respect for autonomy, moral agency and dignity, physicians ought to respect patient's needs. It is now time to renew efforts to avoid negligent disclosure and implement a patient-centered model of informed consent.

中文翻译：

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手术知情同意权的侵犯：信息披露的疏忽及其对公立综合医院外科医生信任的影响——患者的心声。

背景毫无争议的是，手术知情同意书的理想道德标准要求外科医生在患者签署知情同意书之前与患者进行披露对话。这项叙述性研究首次将患者关于披露对话的经历与患者-外科医生的信任联系起来，这对于有效康复和更高的依从性至关重要。方法 受访者为 12 名以色列人（6 男 6 女），年龄 29-81 岁，接受了挽救生命的手术。使用滚雪球采样来定位参与者出院后的初始恢复过程。结果我们的经验证据表明，这侵犯了患者接受充分的、尊重其自主权的披露对话的权利。超过一半的参与者在没有披露对话的情况下签署了知情同意书，因此感到焦虑、受骗，对外科医生失去信任。外科医生取消了知情同意的意义，而不是提升了参与者的道德能动性和尊严。讨论 参与者的不愉快经历之间的相似性使我们认为，取消手术知情同意的行为不仅仅源于时间和资源的限制，而且可能反映了保留这种行为并导致患者客观化和坚持家长作风的潜在悖论。我们提出了一种多阶段数据驱动的知情同意模型，可以满足患者的需求并促进患者对外科医生的信任。结论 患者经历证明患者尊重自主权受到侵犯。为了满足尊重自主权、道德能动性和尊严的表面权利，医生应该尊重患者的需求。现在是时候重新努力避免疏忽披露并实施以患者为中心的知情同意模式了。