Have you ever undergone any operation like gall bladder removal or appendectomy or for hydrocele? I am sure you gave your consent for the surgery. Did you understand the understand the procedure and the possible complications? The common sense approach is that before conducting any procedure the physician discusses the natural history of disease and the available treatments both surgical and otherwise. In case of surgery the procedure should be explained in layman terms including the preoperative preparations, the anaesthesia and surgery itself and the expected recovery and the untoward events that can happen. The common sense approach is that all possible complications having a greater chance than 1% are discussed with the patient and subsequently a written and signed form included in the notes. In the present day scenario with increasing medical bureaucracy and distrust a signed consent form in the medical records has become the end all. An example is the change required from the Mayo’s clinic following their legal entanglement. I quote-
Mayo”s long-standing practice had been for doctors to give patients detailed oral explanations of the risks, benefits and alternatives to a procedure and to get verbal consent and document it in patients” charts, spokesman Brian Anderson said. Patients weren”t asked to sign specific consent forms, he said. “We”ve always had an informed consent process,” Anderson said. “That is certainly critical, ethically paramount.”
Similarly one of my former institution required a hand written consent of few lines basically stating that the patient was aware of the possible complications including death (which is true though rare) and consented for the procedure. I would be surprised if the patients who indeed developed complications did feel informed later in retrospect. The sad thing is; there is no escape from law- the form is the only thing that matters 6 months hence. Image courtesy: Fannie-Annie
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