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Is there a standardised consent process within the surgical specialties?

James Hall1, Ian Farrell1, Sujala Kalipershad1

  • 1Department of General and Colorectal Surgery, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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Surgical consent practices vary significantly across the UK, with many surgeons not adhering to national guidelines for informed consent. Improved time and infrastructure are needed for better patient consent processes.

Keywords:
ConsentMontgomeryStandardisedSub-specialtiesSurgeryThebaut

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Area of Science:

  • Medical Law and Ethics
  • Surgical Practice
  • Patient Safety

Background:

  • Informed consent is a cornerstone of surgical practice.
  • Landmark legal cases emphasize a staged approach to consent.
  • Current surgical consent practices require evaluation against established guidelines.

Purpose of the Study:

  • To assess the homogeneity of surgical consent practices in the UK.
  • To compare current consent procedures with national guidelines.
  • To identify variations in how surgeons obtain informed consent.

Main Methods:

  • An anonymous online survey using Google Forms was distributed to surgeons across the UK.
  • Data collection focused on principles derived from the Montgomery guidelines.
  • Key areas surveyed included consent timing, patient information, and use of risk communication tools.

Main Results:

  • Over 325 responses were analyzed, revealing significant practice variations.
  • A majority of consent (50.8%) occurred on the day of surgery, with only 27.3% involving scheduled meetings.
  • While 65.8% routinely provided copies of consent forms, only 32.9% used pre-printed forms, and 64.3% rarely used specific risk percentages.

Conclusions:

  • Significant heterogeneity exists in surgical consent practices despite clear best practice guidance.
  • Most surgeons desire a more robust consent process but face challenges with time and infrastructure.
  • Addressing systemic barriers is crucial for enhancing the quality of informed consent in surgery.