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The Surgical Informed Consent Process: Myth or Reality?

  • Miguel A. CaínzosEmail author
  • Salustiano Gonzalez-Vinagre
Chapter

Abstract

Informed consent is currently considered to be a highly important factor which is becoming a critical component of surgical practice. It is a complex process and not just an event or a single encounter. In the twenty-first century, it is accepted that the traditional paternalist relationship between the patient and physician has been replaced by a new type of relationship in which the patient detents a very active and crucial role. For patients who need a surgical procedure, the informed consent process represents the honing of this link between the surgeon and his or her patient. The legal principle emphasizes the fact that the patient is an independent adult who has the capacity to authorize what is going to be done to his or her body. This is a process with significant ethical and legal aspects where both the surgeon and the patient play a major role.

The components which make up the informed consent process are the preconditions, the information provided to the patient, and the consent itself. The most complex step of the informed consent process for the surgeon is providing correct, truthful, unbiased, and accurate information to the patient while keeping hope in him or her. The physician disclosure has three stages: the disclosure of information, the patient understanding, and the patient decision-making. It is necessary to adapt the information to each patient in a language they can always understand. The physician must provide information about the surgical procedure, the benefits, the associated risks, potential complications, and alternative procedures, if any.

Surgeons must use all the available tools to adequately inform the patient and the relatives and improve his or her understanding: information leaflets, multimedia interventions, decision aids, the Internet, and government and professional organization guidelines. New tools as surgical risk calculators which estimate patient-specific postoperative complications for different procedures are now available.

The ultimate goal of the informed consent process should be fostering the patient’s trust in his or her surgeon.

Keywords

Surgical informed consent Physician disclosure Trust Shared decision-making Tools for improving information 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Miguel A. Caínzos
    • 1
    Email author
  • Salustiano Gonzalez-Vinagre
    • 1
  1. 1.Department of SurgeryHospital Clínico UniversitarioSantiago de CompostelaSpain

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