Informed consent in the OR

Most operations are planned, which gives patients the opportunity to ask questions and deal with consent issues. Although consent forms differ depending on the institution, they should include the name of the doctor performing the operation and the procedure you're authorizing. It might also ask permission to administer anesthesia and attend to unforeseen problems discovered during surgery.

A teaching facility might ask for approval for other things as well, such as use of photographic or other nonmedical equipment and the presence of observers. Some hospitals and doctors will hand you a consent form early on; others will offer it closer to surgery, maybe even the same day.

If you have concerns about who will be providing your surgical care, experts suggest that you:

Request the surgical consent form in advance of your operation and give yourself enough time to read it.

Consider who will perform all aspects of your procedure, including the anesthesia.

Educate yourself about the facility's and surgeon's policies on teaching and supervising students and trainees.

Ask if the surgeon is going to perform the entire operation.

Find out if the surgeon will be present the entire time, and if not, how long he might be gone and who will be in charge during his absence.

Cross out parts of the consent form you are not in agreement with and write down your expectations, initialing the changes, but discuss it with your surgeon first. Don't wait until the last minute.

Realize that if your surgeon disagrees with you, he could cancel your operation and you might have to find another doctor. You, too, can call off your operation.

Make sure your surgeon is named on the consent form; don't sign a blank form.

Inquire about the policy for informing patients about changes in who will perform parts, or all, of your operation.

Remember that informed consent involves more than just filling out a form. It involves communication and transparency. Try to be respectful and nonconfrontational throughout this process.

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