What is consent for (before an operation)?
The principle of informed consent ensures the freedom of individuals to make choices about their medical care. It is the patient, not the doctor, who ultimately must decide if treatment is to be administered. It normally takes the form of written consent, i.e. you stating you are happy to proceed with the operation or procedure and understand the risks.
So. Why is consent needed before an operation or procedure?
Before we answer this good question, we will start with the basics.
What is consent?
Consent refers to the process of you giving your permission to have a treatment (or investigation) that has been recommended.
It is best practice to be done a few weeks (and less than 2 months, so you can remember it) prior to an operation (or significant procedure, e.g. a colonoscopy) – if it is a non-urgent one. This gives you time to mull it over, explore other options and ask questions.
Where is consent done?
This is most often done in the outpatient clinic when the options are discussed and the decision agreed between you and the doctor – i.e. as to which treatment you would like to proceed with.
Who obtains consent from you?
Ideally the surgeon (or health professional doing the procedure) will ask you to sign a consent form indicating your agreement and detailing benefits, risks and alternatives.
For cancer operations there will normally be a cancer nurse who will go through the process as well. There is often a specialist nurse also for some non-cancer operations to help you understand it all.
You may be given written information about the operation. The consent form will be reaffirmed when you come for surgery.
But why is consent done?
Ok, we have not actually answered the question yet [“I feel you are stalling” CKDEx].
Ok, ok, you are right Ed. The short answer is there is no accepted answer, and also no accepted answer to why it is needed for this level of operation or procedure but not that.
It is clear that if you need a major operation (e.g. a hip replacement) consent is needed and obtained.
But, for example, having a tooth removed, crowned or filled is an operation. There is a surgeon there (dentist) with specialist surgical equipment. But consent is not normally obtained.
Having a colonoscopy is a procedure and consent is obtained. But it is not if you have a needle put into a vein for intravenous fluids and antibiotics. The needle, fluids and antibiotics can all lead to serious side effects (even death). But consent is not obtained.
CKDEx thinks that ‘the why’ (i.e. why consent is needed) is do with these three factors:
- Significant risk
- Unable to change your mind – when under general anaesthetic, or sedated – so not able to stop the operation or procedure
- Medicolegal protection for the doctor (or health professional) doing it – i.e. if you sue them if it goes wrong, they have a degree of protection.
Note. All of the above may be true, but often in such issues, there is no why. Its just historical – to do with how things have developed in the medical, legal and social/cultural world as years have gone by.
Summary
We have described why consent is needed before an operation or surgery. Some of the why is historical. We hope it has been helpful.
