Informed Consent – It’s neither, really, but who’s counting.


When you meet with your surgeon to discuss your operation, you will be asked to sign a “consent” document for surgery. That document should list the planned operation and the name of the doctor who will be performing the operation. All of this will be a small part of a long document with a lot of legal language, basically saying that by signing the paper, you agree that you know all about the risks and benefits of the operation, and accept the risks. Both you and your doctor need to sign this document before you can go to the operating room.

The reality, of course, is that truly informed consent means much more than signing your name to a piece of paper saying that the risks and benefits of the operation have been explained to you. The consent document is just one step in the informed consent process, and it’s far from the most important one.

Informed consent means that:

  • You and your surgeon talk about the risks and benefits of your operation
  • You have a chance to ask questions
  • Together you and your surgeon agree on a course of action.

Different people may want to know different amounts about their operation, but it’s important that you have a chance to have your questions answered to your, and your family’s, satisfaction. Signing the informed consent form means that you agree that you had that conversation – it doesn’t take the place of it.

Here are some key questions to ask your surgeon before you sign the informed consent document.

–    What are the alternatives to this operation?
Ask your surgeon if there are other operations, or even nonsurgical options, to treat your condition. You might also ask whether there are other physicians who offer treatments that your surgeon doesn’t. No one will be upset with you for asking these questions – it’s your right to be fully informed of all your options before you sign on to have an operation.
–    What are the risks of surgery?
It’s not possible to list every single bad thing that can happen as the result of an operation, but your surgeon should discuss the most common and the most serious complications associated with your operation. Some operations have complication rates of 20% or higher, and you should be prepared for the possibility that things could go wrong after surgery. Nobody, least of all you or your surgeon, wants a complication to come as a complete surprise.
–    What are the benefits of surgery?
To weigh the risks of surgery, you need a real understanding of what you stand to gain by having an operation. How effective is the operation at treating your condition? What level of function can you expect to regain? What will the recovery time be?

Many informed consent documents include consent to receive blood products from blood donors if necessary. Obviously, the chance that a blood transfusion will be needed during an operation varies tremendously, depending on the operation, and is almost always extremely low. However, blood product transfusions have their own risks and benefits, and you should go through the informed consent process for this as well.

When the time comes to sign the consent form, be certain that it says what you think it should: If you are having an operation on one side of your body, the consent should include the worlds LEFT or RIGHT in big letters. The procedure listed should be the one you and your surgeon discussed. And your surgeon’s name should be listed as the person performing the procedure. Checking these details is all part of your being an engaged advocate for your own healthcare.

Finally, if the patient can’t provide consent on their own, that responsibility goes to the designated healthcare proxy. Generally, that means the parents of minors, spouses, or parents, adult children, or siblings of unmarried patients. It’s important to be sure that your family understands your wishes for healthcare, in case they are ever called upon to provide consent for you. But that’s a topic for another post.

Remember, signing the informed consent document doesn’t mean that you don’t get to ask more questions, or that you can’t change your mind about having an operation. You should always feel comfortable asking your surgical team any questions that you have, right up until you roll into the operating room.

This story originally appeared in the  Health Dialog Care Compass Blog.

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