Both patient and surgeon have important roles in the process of informed consent.
Surgeon role:
Obtains informed consent. Provides information about the surgical procedure. During the discussion to obtain consent the surgeon should present to the patients the indications, technical aspects, and explain in detail the most common complications and give an indication of how frequently each occurs.
1. Indications
The reasons why the operations is recommended. Why it is being done.
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Anatomy of tissues where the surgery will be done including a description of how the respective tissues types heal. Nearby risky structures (vessels and nerves) are subject to injury which could be associated with adverse (pain, hemorrhage, nerve injury) consequences for the patient. special equipment: advantages and risks.
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Problems that could arise (and have to be dealt with immediately) during surgery, as well as problems that could occur early or later post operatively (with acute and chronic management requirements). Percentages of risk occurrence and outcome when available and accurate.
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4. Alternatives
Therapies (medical as well as surgical) that could be done INSTEAD of (not in addition to ...) the proposed surgery and achieve the same therapeutic objective as the proposed surgery.
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Patient role:
Attentive listening. Formation of appropriate, comprehensive questions relative to the information presented by the surgeon.
Once the information has been presented to the patient (or a duly empowered to act as a patient's health care decision maker) and that individual indicates his/her: 1. Comprehension and 2. Assent, the surgeon (or in some cases a designated agent) signs, as well as the patient (or agent), and a third party (not party to the consent surgery) "witness".
Patients rights in most hospitals include the right of the patient (or his/her agent) to at any time and for any reason, revoke a previously granted informed consent.
Patient agents (spouses, family members, significant others, friends, conservators, guardians) frequently give informed consent on behalf of neurosurgical patients with intracranial pathology such as brain tumors, ruptured aneurysms, and encephalitis.
The surgeon not only signs the same informed consent form as the patient (or representative) but he/she in addition writes a statement in the medical record (patient chart) indicating the nature and content of the informed consent as part of his/her preoperative documentation.
The informed consent protects both the patient and the surgeon:
Patient: Ensures that patient will be given information necessary to make an "informed" decision about the proposed surgical treatment.
Surgeon: Documents that the appropriate information was given and that the patient (or agent) sufficiently understood and agreed to sign the Informed Consent form.
INFORMED CONSENT Reasons why patients do not “remember informed consent conversation
Friends and/or relativesPro: translators “medical” background – familiarity with terms
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