[Informed consent in the surgical patient. Reflections on the basic law of patient autonomy]

Informed consent is the final step in informing the surgical patient. The basic law of patient autonomy specifies the conditions in which patient authorization should be given with the aim of guaranteeing that a free decision is made. However, surgeons are sometimes faced with clinical situations in which it is difficult to obtain informed consent, whether because the patient is unable to provide consent or because of the need to intervene in a life-threatening situation, or because the informed consent document must specify the risks and consequences of the intervention. The present article aims to analyze what happens when the patient is unable to provide consent ("consent by representation") and the characteristics of the informed consent document according to the stipulations of the basic law of patient autonomy.