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Informed Consent

The common types of consent when it comes to surgical practice are;

Implied consent would for instance include asking the patient their name and what they were complaining of; the patient has come to the doctor for assessment and it would be reasoble to ask them these questions. Another type of implied consent would occur after verbal consent in the case of physical examination and taking blood or inserting an iv cannula. You ask the patient to permit you to take some blood and they hold out their arm, they are therefore implying that they consent to having their blood taken.

Verbal consent would be spoken between the doctor and the patient. For instance the doctor says ...May I examine your tummy? and the patient repleis yes, hops up on the couch and exposes the tummy. This would be verbal and implied.

For most operations implied and verbal consent is not considered enough, a formal written consent must be made. This is the type of consent that a patient gives for an operation. This type of consent should be informed; Informed consent means that there has been a discussion of the risks, benefits and alternatives to the proposed treatment. You should explain the procedure to the patient in terms and words that they understand, thus this must be tailored to the individual patient. The major risks must be explained along with the rate that these might be expected. Do not forget to remind the patient of the benefits of the procedure, after all you are trying to inform them of their choices and they need this information to make that decision. Communicate with the patient, check to see that they understand what you have told them and ask them if they have any questions about what you have discussed so far. If the decision is complex, you may need to discuss it with the patient on several occasions so that they understand. If the patient is having difficulty in reaching a decision, suggest to them that they discuss it with their GP or agree to meet with the patient and a confidant if desired. Documentation of the consent is an important part of the process. You should make a note in the patient's notes about what you have discussed. In addition, a consent form should be signed, some units have prepared consent forms with a detailed outline of the risks, benefits and alternatives which a patient is given a copy of. These type of forms are attractive but not widely available in this country heretofore.


next up previous index Surgical Topics
Next: Mechanical Bowel Preparation Up: Preparation for surgery Previous: Preparation for surgery   Index
Adrian P. Ireland