Informed consent for congenital hypothyroidism screening: Practices and attitudes of midwives in eastern Morocco

Abstract

Informed consent (IC) is a major element of medical ethics in interactions between clinicians and patients. This study aims to describe midwives' attitudes towards informed consent for neonatal screening for congenital hypothyroidism (NSCH). To achieve this, a questionnaire was sent to 64 midwives responsible for neonatal screening program in the public sector in eastern Morocco. Only 37.8% of midwives reported always informing the mothers about this process. A statistically significant association was revealed between the frequency of providing information and the midwives' level of knowledge (OR :14,4; IC 95% [2,68 - 77,8]; p=0,002). Paradoxically, the informed mothers were more likely to ask questions than those who weren’t (OR: 24,0; IC 95% [5,37 - 107,2]; p<0,01). 34.7 % asked about the procedure for handling and the treatment in case of a positive test. 62.5% of midwives declared that they did not ask for parents’ permission of whom 57.8% considered NSCH as a compulsory program, but 56.8% of refusals were accepted without further discussion. 39.1% of them assumed that it was due to mothers' lack of knowledge of the program. In conclusion, improving the informed parental consent to neonatal screening is strongly linked to improving the knowledge of both midwives and parents.