Evolution of consent and alternatives to traditional consent forms

Abstract

Consent is an essential part of surgical practice. However, it suffers from a number of problems. Firstly, the consent form does not tend to hold significant weight in evidence to demonstrate informed consent was obtained despite the fact that this is almost its sole purpose. The consent process tends to focus on negative aspects, such as complications, and is often timed immediately preceding surgery which is not ideal for patients whom are already anxious and often told a long list of potential complications immediately before surgery. A request-based system of consent has recently been published that allows a more constructive and patient-centric approach, provides powerful evidence of consent and understanding as it is written by patients in their own handwriting and vocabulary, and takes very little time to obtain as it is often undertaken as “homework” by patients armed with good quality information resources prior to admission. An overview of consent and request for treatment (RFT) is provided in the context of otoplasty.