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Obtaining an ‘informed’ consent for primary percutaneous coronary intervention (PPCI) in non-English speaking patients…the dilemma

This problem is accentuated in a multi-ethnic society where some patients do not speak the national language at all. According to the 2011 census 138,000 people living in England and Wales do not speak any English. 2 Not infrequently, we do encounter non-English-speaking patients presenting with acute myocardial infarction and requiring treatment with PPCI. Despite being a lifesaving procedure, PPCI carries the risk of major complication such as stroke, heart attack and death. When the procedure is explained to English-speaking patients, some of them refuse this lifesaving procedure due to the risks and potential complications involved. We should therefore assume that non-Englishspeaking patients should have the same opportunity to make an informed consent to the procedure. The dilemma then arises as to how to obtain an informed consent from patients who speak no English when no other family or staff member can help translating.