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Consent

While the general topic of consent to treatment is discussed in Chapters 12 and 13, surgical consents pose certain special problems. Primary among these is that it involves two procedures by independent physicians. The purpose of informed consent to surgery, as with all other informed consents, is to obviate misunderstandings between the physician and the patient. Through a thorough discussion of the procedure, its risks, and the alternatives, the patient is given a chance to accept the procedure and its possible complications emotionally as well as intellectually. Patients may decline the surgery because the risk-to-benefit ratio is too high for their personal risk-taking profile.

The informed consent process is also a time for the patient and the surgeon to discuss nonmedical considerations that may affect the decision to have surgery, or at least its timing. A patient may want to postpone elective surgery to attend a wedding or other special event. If the surgeon does not know this and forces the patient to miss the event, the patient will be much less tolerant of complications of surgery. Surgeons should also explain any special considerations in their own schedules. Patients should be told if the surgeon is going out of town after the surgery. In this case, the patient should be told who will be handling any postsurgical care. If the planned surgery is elective, the patient may choose to wait until the surgeon returns. It may also be to the surgeon's benefit not to schedule elective surgery for the week before leaving town. Patients and family are always angry if something unexpected happens and the surgeon is unavailable.

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