Medicine, surgery and anaesthesia offer services to patients, to which they need to agree, and it has to be in their best interests. Therefore, consent for surgery takes a critical place in the legal position of interventional treatments.

In medical terms consent is the provision of approval or agreement to a medical treatment. As such medical consent is a contract between caregivers and patients. In this chapter we will discuss the types of consent, the mechanisms of obtaining consent and the ethical issues surrounding it.

All medical interventions have intended benefits, success rates and complication rates. In addition the consequences of omitting a medical intervention have to be considered, as well as any potential alternative treatment options.

Consent is a process, and has several potential aspects to it:

Written consent

Written consent is a document, which explains that a competent medical practitioner offers an intervention to a patient, explains the intended benefits, with their success rates, as well as possible complications and alternatives. The document has to be signed and dated by both parties, preferably after sufficient time to allow the patient to assimilate the relevant information that will allow a fully informed decision to be made. This then begs the question: who is deemed a competent medical practitioner? In theory this could be a doctor who could potentially carry out the intervention, but ideally it should be the operator. It is important this documentation is carefully stored for medicolegal reasons.

Verbal consent

Verbal consent is given by using verbal communication. Interestingly, written consent for general anaesthesia is not mandatory in UK, and indeed implied in the surgical consent by stating the procedure will be carried out under general anaesthetic. There has been a movement to change this practice in the future.