Informed Consent

Consent is a conversation, not a signature

In many hospitals, 'consent' means a form pushed across a counter minutes before a procedure. That is not consent. It is paperwork.

Real informed consent means you understood what is wrong with you, what is being proposed, what else could be done instead, what could go wrong, and what happens if you do nothing — and then decided. The form records that conversation. It does not replace it.

At SIMS the conversation happens in the language you follow best, with the doctor who will perform the procedure or a member of that team, and with enough time for you to ask questions and, wherever the situation allows, to think it over.

What must be explained before you consent

If any of these has not been covered, you are entitled to ask before signing anything.

• Your diagnosis, or the working diagnosis if it is not yet certain, in words you understand
• What the proposed procedure or treatment involves, and what it is expected to achieve
• The realistic alternatives, including more conservative treatment and the option of doing nothing for now
• The risks and possible complications — the common ones, and the serious ones even when they are rare
• The likely recovery: how long in hospital, what restrictions afterwards, what follow-up is needed
• Who will actually perform the procedure, and whether trainees will be involved under supervision
• An estimate of the cost, what your insurance is expected to cover, and what you may have to pay yourself
• What could change during the procedure and require a different or extended intervention

Who can give consent

Consent belongs to the patient. It passes to someone else only where the patient cannot give it.

Your right to refuse, and to change your mind

You may refuse any test, treatment or procedure, including one your doctor strongly recommends. You may also withdraw consent you have already given, at any point before the procedure begins. Refusing does not end your care and it does not make you a difficult patient — you will be told clearly what the likely consequences of refusal are, asked to record that decision, and continue to be treated for everything else.

You may also ask for a second opinion before deciding, from another consultant at SIMS or from outside the hospital, and we will make your reports available so that opinion is properly informed. A decision worth making is worth taking time over.

Consent given for one procedure does not extend to another. If circumstances change during an operation and something different becomes necessary, that is explained afterwards and documented, and further consent is taken for anything that can wait.

Photography, teaching and research

These are always separate from your treatment consent, and always optional.

• Clinical photographs of a wound, lesion or scan may be taken for your medical record; using them for teaching or publication requires your specific written permission
• Any image used beyond your own record is de-identified, and you may refuse permission or withdraw it later without affecting your care
• Where trainees observe or assist in a procedure under supervision, you are told and may decline
• Participation in any research study is entirely voluntary, explained separately, and consented to in writing — declining changes nothing about the treatment you receive
• Your medical records are not shared with insurers, employers or third parties without your written authorisation, except where the law requires disclosure