Written consent for laparoscopic tubal occlusion and medico-legal implications

To analyse the completeness of written consent for laparoscopic tubal occlusion and to consider the medico-legal implications of incomplete written consent.

A retrospective review was undertaken of the medical records of all women who had laparoscopic tubal occlusion in 2006 in a district general hospital to elicit details of risks of the procedure as recorded on the consent form. The extent of documentation of risks and complications that were cited in the guidelines was analysed. In addition, the grade of doctor and the timing of obtaining written consent were studied.

A total of 267 women underwent laparoscopic tubal occlusion and 214 (80.1%) case notes were reviewed in the present study. The findings demonstrate wide variation in the description of risks by doctors of different grades. The majority of written consents (65.9%) were obtained on the day of surgery. In most cases (75.2%) trainees were responsible for obtaining written consent.

Although the written consent form is a legally effective document, the process of documentation is inconsistent and this may leave the senior gynaecologist in a vulnerable position.