Informed consent for elective surgery: what is best practice?

Thank you for publishing the review by Andersen & Wearne (JRSM 2007;100:97-100).¹ It was an informative and interesting article, which communicated the essence of informed consent in a manner that everyone—particularly medical students—would find easy to understand.

The teaching of informed consent, and the seriousness of being able to ensure that a patient is competent to make a decision—either for or against any medical intervention requiring such—has been thoroughly taught to myself and my peers from our first term at medical school. However, the importance of making sure that you are suitably qualified to take informed consent for a procedure that you are seeking consent for (e.g. the authors mention that current guidance state that ‘the person obtaining consent must either (1) be capable of performing the procedure themselves; or (2) have received specialist training in advising patients about the procedure’) is often not communicated enough.

Perhaps such a concern can be best explained by the undeniable fact that often juniors take informed consent, more times than they maybe should, for procedures they are not experienced enough to conduct themselves. As for the second criterion, some juniors might not have received such specialist training before taking consent.

This is just one sticky point surrounding informed consent that the authors only touch on lightly. Through the mechanistic overhaul of the profession that is MMC, one wonders whether every single surgical procedure is going to be explained, and consent sought, by those who fulfil the above two criteria. It should be for the peace of mind of both doctor and patient.