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From understanding to agreement: The current state of informed consent in Nigerian endoscopic practice
Kenechukwu C Okonkwo, Pantong Mark Davwar, Yusuf Musa, Matthew O Bojuwoye, Chinwe Philomena Onyia, Stella-Maris C Egboh, Shirley N Chukwurah, Emmanuel Obasi, Olutoyin I Asaolu, Winnifred N Adiri, Uchenna F Okeke, Nasiru Altine Dankiri, Chioma F Udigwe
Kenechukwu C Okonkwo, Department of Internal Medicine, Federal Medical Centre, Owo 340108, Ondo State, Nigeria
Pantong Mark Davwar, Department of Internal Medicine, Jos University Teaching Hospital, Jos 930241, Plateau, Nigeria
Yusuf Musa, Department of Internal Medicine, Federal Teaching Hospital Katsina, Katsina 820101, Nigeria
Matthew O Bojuwoye, Department of Internal Medicine, University of Ilorin Teaching Hospital, Ilorin 241102, Kwara, Nigeria
Chinwe Philomena Onyia, Winnifred N Adiri, Department of Medicine, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
Stella-Maris C Egboh, Department of Internal Medicine, Federal Medical Centre, Yenagoa 560231, Bayelsa, Nigeria
Shirley N Chukwurah, Chioma F Udigwe, Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi 435101, Anambra, Nigeria
Emmanuel Obasi, Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki 400101, Ebonyi, Nigeria
Olutoyin I Asaolu, Department of Internal Medicine, Evercare Hospital, Lekki 106104, Lagos, Nigeria
Uchenna F Okeke, Department of Internal Medicine, University of Port-Harcourt Teaching Hospital, Port-Harcourt 500001, Rivers, Nigeria
Nasiru Altine Dankiri, Department of Internal Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto 840101, Nigeria
Author contributions: Okonkwo KC, Davwar PM, Musa Y, Bojuwoye MO, Onyia CP, Adiri WN, Egboh SC, Chukwurah SN, Udigwe CF, Obasi E, Asaolu OI, Okeke UF, and Dankiri NA drafted the questionnaire; Okonkwo KC, Davwar PM, and Musa Y analysed and interpreted the data, and drafted the initial manuscript; Okonkwo KC, Davwar PM, and Musa Y, Bojuwoye MO, Onyia CP, Adiri WN, Egboh SC, Chukwurah SN, Udigwe CF, Obasi E, Asaolu OI, Okeke UF, and Dankiri NA were involved in the final revision of the manuscript. All authors approved the final version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors are guarantors and participated in the study design. All authors participated in data acquisition.
Institutional review board statement: Ethical clearance for the study was obtained from the University of Medical Sciences, Ondo State Health Research and Ethics Committee, reference number NHREC/TR/UNIMED-HREC-Ondo St/22/06/21.
Informed consent statement: All participants consented before joining the study.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Yusuf Musa, MD, Chief Physician, Department of Internal Medicine, Federal Teaching Hospital Katsina, Murtala Muhammad Way, Opposite Jibia Road, Katsina 820101, Nigeria.
yusuf.musa@npmcn.edu.ng
Received: May 7, 2025
Revised: June 12, 2025
Accepted: November 17, 2025
Published online: June 20, 2026
Processing time: 351 Days and 14 Hours
BACKGROUND
Informed consent is a cornerstone of ethical endoscopic practice, ensuring that patients understand and agree to the procedures that they undergo. Despite its importance, studies suggest that variations in consent practices persist. There is also a paucity of information on endoscopic consent practices in sub-Saharan Africa.
AIM
To investigate current practices around consent taking among endoscopists in Nigeria.
METHODS
This cross-sectional survey was conducted from August to September 2024 among endoscopists practicing in Nigeria. The participants completed a 32-part self-administered online questionnaire that documented the experiences of endoscopists concerning consent taking in endoscopy practice. These included the location of practice, awareness of legislation concerning informed consent in Nigeria, patient autonomy, various procedural risks discussed with patients, and challenges faced. At the end of the survey, the responses were analyzed using tables, pie charts, and figures.
RESULTS
A total of 68 participants responded to the questionnaire. The mean age of the participants was 45.2 ± 6.6 years. There were 26 (38.2%) females and 42 (61.8%) males. Participants practicing in the northern part of the country comprised 41.1% (30) of the participants, while those practicing in southern Nigeria were 58.9% (38). Only 49.3% were aware of legislation about informed consent in Nigeria. The majority of the study participants (69.1%) gave the patients a few minutes to digest information before the procedure. A variety of risks were reported to be discussed, with abdominal discomfort being the most common (83.8%). The challenge to adequate consent was inadequate time for consent taking due to high patient burden (60.6%).
CONCLUSION
Consent taking for endoscopy in Nigeria is not ideal; many healthcare workers only gave patients a few minutes to understand information about the procedure. To address this, training workshops and online webinars should be organized to train medical staff on how to do it properly. This will help improve patient care, ensure safety, and lead to better health results for patients.
Core Tip: Consent taking is important in endoscopic procedures so as to optimize procedural safety and patient outcomes. This is ethically important as part of good endoscopic practice. The process of consent taking is suboptimal in Nigeria. Specific measures such as training workshops and online webinars for endoscopists should be regularly held to improve the process in Nigeria.
