When a communicatee does not comprehend what the communicator is trying to explain, it is the communicator’s job to try harder. Modern medicine enabled by cutting-edge technology, offers patients life-saving procedures with tremendous advantages. Yet, despite these advances, one of the most sensitive aspects of any doctor’s daily practice is not the treatment itself, but the conversations that happen before it. A large proportion of unhappiness, complaints, and even litigation in medical practice revolves around two commonly encountered themes – that a patient was not adequately informed about a procedure (or its risks) or he was not given enough time to decide. Both these are related to one simple but vital step - proper consent. My last article was about how trust on the treating team during medical or surgical emergencies can help saving time and lives. This article deals with conversations prior to nonemergency (elective) medical situations. Consent prior to a procedure is not just a medical or legal formality, it is the foundation of trust between doctor and patient. It ensures that a patient knows what lies ahead, feels respected in their choices, and participates actively in their own health journey. Let us explore what informed consent truly means, why it is a shared responsibility, and how both doctors and patients can work together to make this process smooth and meaningful.
Informed Consent - the two components:
Most people assume that consent is entirely a medical team’s responsibility. While doctors are obligated to provide complete and clear information, consent has two clear components:
= Information – which is a doctor’s domain. It includes explaining why a procedure is needed, how it is performed, what benefits are expected, what risks exist, and what alternatives are available.
= Consent – which is the patient’s responsibility. After receiving the information, it is up to the patient (and their family) to understand, reflect, ask questions, and then decide whether to proceed or not. In other words, doctors inform; patients consent. Both sides must engage sincerely for this process to serve its true purpose.
What constitutes adequate information?
While no amount of detailed explanation can cover every possible eventuality in medical procedures, doctors must make sure that patients receive a comprehensive overview of what to expect. This often includes the following: a brief background about the disease; why a particular procedure is being advised; how is the procedure performed (without unnecessary technical jargon); expected benefits from the procedure; what are the available alternatives (particularly if less invasive and less costly ones are available); what do national or international guidelines recommend and finally possible adverse outcomes with frequency (including how will these complications be managed in the existing healthcare setup). When these points are discussed transparently, the patient and family can make a balanced, informed decision.
Medical language can often be overwhelming. Many patients might nod politely during explanations but walk away with half-understood details. To prevent this from happening, doctors should (could) resort to simple aids such as audio-visual presentations, charts and diagrams or printed handouts that the patient can review at home. These tools not only improve understanding but also reduce anxiety.
Give Time, Never Rush:
In emergency situations, quick decisions are unavoidable. But for planned or elective procedures, patients must never feel hurried. After the initial discussion, adequate time should be given to think, consult family members, and even seek a second opinion if needed. This pause is not a delay in care—it is an essential step in ensuring that the decision is truly the patient’s. A rushed consent is often the root of later regrets and disputes.
Respect a Patient’s Choice:
Sometimes, despite a doctor’s best explanation and recommendation, a patient may refuse the suggested procedure. In such cases, it is natural for doctors to feel concerned, even frustrated. But the principle of consent is very clear: it is the patient’s body and the patient’s choice. If a patient refuses, this must be documented carefully, and medical management should continue with compassion. Most importantly, the patient should not be made to feel guilty or pressured. The role of a healthcare provider is to provide care, not force it. Respecting refusal is as important as respecting agreement.
Why All This Matters:
When patients feel involved in their own care, trust in the healthcare system grows. When doctors know that their patients understand the road ahead, they feel reassured. This shared responsibility reduces bitterness, misunderstandings, and avoidable disputes. At its heart, informed consent is not about paperwork or signatures. It is about honest dialogue, mutual respect, and shared decision-making.
A Take-Home Message for patients:
If you or your family ever face the possibility of a medical procedure, remember these key points: ask questions freely; take your time; use resources (diagrams, videos, or handouts if needed); respect the balance – information is the doctor’s duty; consent is your responsibility and finally take ownership of your decision (whether you say yes or no, it is your right). As doctors, we are here to guide, explain, and support. But at the end, it is one’s own health and body. Only when this partnership between doctor and patient is understood and honoured can medicine truly achieve what it is meant for: healing without mistrust, and care without compulsion.
Prof Hemant Madan is an Interventional Cardiologist and Programme Head, Cardiac Sciences for Narayana Health.
