Insight, Inspiration, Motivation

When is the Best Time to Get Informed Consent?

You may wonder what this question is all about. Let me explain. There are many points of contact between a physician and a patient consenting to a procedure, when an informed consent can be obtained. The first point of course, is when the surgeon first informs the patient that they need surgery. Most of the time, patients agree to the procedure, and are put on the waiting list immediately. In many hospitals, the booking cannot even proceed, unless the signed consent for is sent along with the booking information. Usually, the pros and cons are explained to the patient right away, and the consent is signed.

I find that this may be too soon. I always give the patients a handout, containing detailed information about their surgery, and instructions as well. (I know that every other surgeon does this too). Should the patient not have the time to take this information home, read and assimilate it, before they sign their consent? Should they not also have the opportunity to do research on their own or ask others for advice, as I am sure everybody does?

Some patients need more time to think about the surgery, and sometimes about different surgical options, before they can decide whether to consent or not. They may just call and inform of their decision, or may want to come in and ask more questions. If they are seen at this point, the consent may be obtained then.

I personally feel that the best time to obtain informed consent is in the pre-operative room. This is when I give them the chance to ask any final questions, and have them answered, both about the surgery, and about the anesthesia. The also get to ask about post-operative care, if they have any questions. This also gives me a chance to re-familiarise myself with their condition, the reasons for operating, and any special considerations that may be required. In some instances, patients do change their minds about the surgical option, and this can be acknowledged as well. This way, I also get to make sure I have seen them and addressed any fears before they are wheeled into the operating room.

i do work in a small hospital, and I am able to do it this way, but I wonder what, if any problems other surgeons have had, when the consent has been obtained weeks in advance.

I invite anyone – physicians, nurses, other healthcare professionals or anyone who has had the experience of going through an operation – to send me their thoughts or experiences about the consent, and when it is signed.

August 17, 2015 - Posted by | Personal Journey

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