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Intraoperative Ultrasound in Spinal Surgery
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Informed consent in spinal surgery.

N V Todd1, N C Birch2

  • 1Newcastle Nuffield Hospital, Newcastle upon Tyne, UK.

The Bone & Joint Journal
|April 2, 2019
PubMed
Summary
This summary is machine-generated.

Informed consent failures, not surgical errors, led to legal issues in spinal surgery cases. A proposed checklist can improve patient communication and provide legal evidence for surgeons.

Keywords:
Clinical negligenceInformed consentLegal judgementsSpinal surgery

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Area of Science:

  • Medical Law
  • Surgical Ethics
  • Patient Safety

Background:

  • Informed consent is crucial for surgical procedures, yet legal challenges often arise from issues within the consent process rather than surgical technique.
  • Past legal judgments in spinal surgery reveal that failures in adequately informing patients about surgical risks and alternatives, or overstating benefits, are common grounds for litigation.

Purpose of the Study:

  • To analyze legal judgments in spinal surgery concerning informed consent to identify common deficiencies.
  • To propose a practical solution to mitigate risks associated with the informed consent process in spinal surgery and orthopaedics.

Main Methods:

  • Review of legal judgments specifically related to spinal surgery where the surgical procedure itself was not criticized.
  • Identification of recurring themes and specific failures within the informed consent process.

Main Results:

  • Legal faults were consistently attributed to inadequate patient information regarding surgical alternatives and material risks, or to exaggerated claims of surgical benefits.
  • A significant number of surgeons could not provide evidence of having discussed specific risks with patients.
  • Specific cases involved unmet promises regarding the operating surgeon.

Conclusions:

  • The consenting process, rather than surgical skill, is a primary source of legal disputes in spinal surgery.
  • A structured checklist can enhance the informed consent process, ensuring comprehensive patient discussion and serving as vital legal documentation.
  • The principles discussed are broadly applicable across all of orthopaedic surgery to improve patient safety and reduce litigation risk.