One of my patients today told me a terrible story of her experience undergoing surgery. I’m not going to recount any of that here of course, but she made such a good point to me I thought I’d share it with you. Maybe you agree?
She said, whenever a drug is prescribed, even if the doctor doesn’t go into a lot of detail about the possible benefits and potential harms, when you pick up the medicine from the pharmacy, the packaging contains a pretty comprehensive description of the product, including a list of the known, potential harms. This, she said, allows a person to make a fairly informed choice about whether or not to take the drug. However, there don’t seem to be any such leaflets available about surgical procedures.
Why not? she asked. There are “generic” potential harms – anaesthetic risks, infection risks and so on – which could easily be desribed, and then, surely there are known “specific” risks related to the intended procedure. Couldn’t the Royal College of Surgeons organise its members to develop comprehensive written information to be given to any patient before an intended procedure? Wouldn’t that allow a more properly informed consent?
I think this is SUCH a good idea. I’m not aware that such a thing exists at the moment. If it does, could you point me to it?
Thank you
Heroes Not Zombies 
I don’t know of any such thing (does webmd have something like it?), but I think it’s an excellent idea.
So much of a patient’s energy is put into trust of the surgeon. I walked into an office two weeks ago never having even MET the doctor before and let her take a scalpel to my forehead right then. I think that informed consent is – or, rather, SHOULD be – a part of the agreement though, having said that, I can see a serious downside for a lot of people. Sometimes and for certain people, full disclosure is too much information. That doesn’t mean, though, that it shouldn’t be made available.
Did that make ANY sense? I’ll clarify if you think I should…
Good gracious! They don’t do that there?! When I was going to have my D&C, to see if they could find any fibroids inside my utereus (and to clean out the lining that wasn’t being shed) they gave me a pamphlet detailing the procedure (with diagrams) the risks, the benefits, and the post-procedure care. The same was done when I had my partial hysterectomy. (Turns out the cantalope-sized fibroid was in the uterine muscle wall itself, and it was pressing on my bladder, causing urine retention, leading to UTIs and Kidney infections. After the 3rd Kidney infection, we all said “Enough is enough!”.) Why not?! You all should, and you should push that suggestion up the line!
Dr. Bob,
I think you are right- to have it universally available is a good thing. Here in the U.S. each Doc (and institution) writes up their own.
chili makes some good points- the info can scare you to death, but it should be there for all who want to see it.
Dr. B
mrschili, I’ve come across the sentiment you express a number of times as a doctor, and I respect it. I would never force my opinion or knowledge on someone but I always, but always, ask several times if a patient wants anything else explained or has any questions whatsoever. I even give patients my email address so they can email me any questions they haven’t thought to ask during the consultation.
In my experience, knowledge is power and if patients are to be empowered the more they know about their condition and the proposed treatments the better.
I think, Doc, that for most people, knowledge IS power. There are people, though, who will take that one-in-one-thousand case statistic and CONVINCE themselves that they’ll be number two. Since a patient’s state of mind is just as important as his or her state of body, giving easily frightened people too much information may not be a good thing.
I like knowing more than less, but I respect people who may not.
Love this idea. I burst into tears when I read the consent form for my breast lumpectomy years ago–it was scary! Turned out to be nothing (benign cyst) but I had to sign to give permission for the surgeon to remove my breast if he felt it was warranted while I was under anesthesia. Something that gives percentages of occurrences would be helpful.
Try this website. A good example of what you are looking for.
http://www.health.qld.gov.au/informedconsent/default.asp
Thankyou, Dr Jamil
That really is a GOOD example.
Thanks for the information on informed consent.
We recently wrote an article on informed consent at Brain Blogger. Failure to obtain informed consent is a leading cause in malpractice claims. When a patient cannot understand what’s happening, things can especially get tricky.
We would like to read your comments on our article. Thank you.
Sincerely,
Kelly
Thanks for the link to Brain Blogger, Kelly. See you there