Most experts tell us that true informed consent is almost impossible, but that does not mean that all of us, doctors and patients should not try to communicate well before surgery.
The California Supreme Court has ruled that doctors should discuss major risks of serious injury and death. How much information needs to be provided about more minor problems is unclear
Modern medicine is so technical that it would require a medical degree and years of specialist training to understand the ins and outs of any surgical procedure. The time available during a consultation is limited and full coverage of any procedure is impossible.
Studies show that many patients have their mind made up before they come for a consultation In these circumstances the patient may not listen to the doctor. Indeed they may be thinking of other things such as the cost or whether they like the doctor. Patients remember only what they want to remember. In one study, even when warned they would be asked questions afterwards, they remembered about one third of what they are told.
Some patients may want to believe that the surgery is risk free. Denial and repression play a large part in the inability to retain information about surgery. Some patients think that if they have a particular doctor they need not worry about the complications. Others feel that they are immune to complications or will not have problems because they take certain medicines, such as vitamins
Many patients come to the doctor with a large amount of inaccurate information which makes it difficult to accept the new information given by their doctor. No matter how hard the doctor tries many patients may not get the information they need to make a good decision. Surprisingly patients who are more nervous seem to remember more than those who are calm. Well educated patients also tend to retain more information.
