Surgical intervention: informed consent
(Photo by Cytonn Photography on Unsplash)
The patient’s duty to be informed is a legal (and ethical) obligation within the contractual nature of the doctor-patient relationship. All practitioners must inform the patient to obtain their consent for the care they will be offered.
“The doctor owes to the person he examines, cares for or advises; fair, clear, and appropriate information on his condition, the investigations, and the care he offers. Throughout his illness, he takes into account the personality of the patient in his explanations and ensures that they are understood … ”.
Medical information can only be given by a doctor. Doctors and paramedics participate in informing the patient, but each does so within their area of expertise.
The notion of informed consent implies that the doctor is required to clearly present all the risks of therapeutic conduct to the patient. To preserve the patient’s autonomy and make him responsible in his decision-making, his consent to the care offered is:
- Free-willing: the patient makes his decision without constraints, he can also refuse care.
- Revocable at any time: the patient can withdraw his consent as soon as he wishes.
- Enlightened: it follows full medical information on the different options of the action to be taken because the patient must be able to participate in the choice among these
—> the frequent or serious foreseeable risks of the different options
—> the foreseeable consequences in the absence of treatment (specific to each stage of diagnosis and treatment of the current problem).
The consent must be dated and signed on the day of the intervention (it does not release the practitioner from his responsibility).
Below is the type of informed consent we use (translated from French):
I acknowledge having received from my surgeon: all the desired information, simple and intelligible, concerning the evolution of the disorders or disease from which I suffer, in case I am not operated.
I have also been informed of the risks to which I expose myself in the event of an operative act, the benefits of this act as well as the therapeutic alternatives.
I acknowledge having been informed that any surgical intervention involves a certain share of risks and a certain percentage of complications, whether they are common or exceptional, including vital ones, linked not only to the disease or disorder from which I suffer but also to individual variations, which are not always predictable. There is an incompressible risk of infectious complications (nosocomial infections) in particular.
I have also been warned that during an intervention, the surgeon may be faced with an unforeseen situation or event requiring complementary or different acts than those originally planned.
I authorize and request, the surgeon to perform any act that he considers necessary under these conditions.
Read, understood, and approved.
(Date and signature)