Peer-reviewed article
Surfactants and the importance of informed consent: Nurturing culturally competent care in healthcare settings
Priyanka Gupta, Vishwajeet Singh, Prince Pareek ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how paediatricians and neonatologists in India obtain informed consent when using surfactant treatments for newborns, and whether they disclose that these medicines come from animal sources. Most doctors (91%) said they get parental consent before giving surfactants, but very few (11%) tell parents about the animal origin, which may conflict with some families' religious beliefs. The study found that healthcare units often do not stock alternatives, and many doctors assume parents would not care about the source.
Key points
- 91.2% of neonatologists reported always taking parental consent before administering surfactants
- Only 10.5% of doctors said they always inform parents about the animal origin of surfactants
- No respondents offered parents a choice between bovine or porcine-origin surfactants
- 33.3% of neonatal care units had both bovine and porcine surfactant preparations in stock
- 23.7% of respondents wanted to offer parents a choice but could not because their units did not stock both types
Limitations
This is a survey of healthcare provider practices and attitudes rather than an evaluation of outcomes for children or families. The study does not measure whether different informed consent practices or surfactant choices actually affect infant health outcomes, parental satisfaction, or adherence to treatment.
Abstract
BACKGROUND: Culturally competent healthcare improves patient satisfaction and clinical outcomes. Many drugs, dressings and implants have human or animal-derived content which may conflict with patients' religious beliefs, and may even have medicolegal implications. METHODS: This cross-sectional study (anonymous web-based survey) was done to understand the informed consent process followed by paediatricians and neonatologists in India, their views regarding disclosure pertaining to the animal origin of exogenous surfactants to patients' families, and their willingness and ability to provide alternative surfactants based on parental preferences. RESULTS: A total of 114 neonatologists/paediatricians involved in neonatal care and using surfactants in their practice responded to the survey. Although 61(53.5%) neonatal care units stocked two or more brands of surfactant in their inventory, only 38(33.3%) units had both bovine and porcine preparations. Most (104, 91.2%) of the doctors always take parental consent before administering surfactants; but only a few (12,10.5%) said they always inform parents about its animal origin. None of the respondents offer parents a choice between bovine or porcine-origin surfactants, most (73, 64%) presuming that it would be irrelevant for the parents. However, many respondents (27, 23.7%) mentioned that they want to offer the choice to parents but are unable to do so because they do not stock both bovine and porcine preparations. CONCLUSION: Although most parents might agree to a life-saving medicine in emergency situations, this does not mean they do not want to be informed. Healthcare professionals should not have a dismissive attitude to parental belief systems. They must use the antenatal period to take the cultural/spiritual history and the necessary consent.