One-size-fits-all approach not best for patient consent

I appreciate the concerns motivating Dr Desmond Wai's proposal, in which he suggests standardised procedures for obtaining patient consent for operations, to ensure patients get all the information they need (Provide standard consent form for medical procedures; Oct 26).

While a framework for ensuring that consent is properly taken is essential, a one-size-fits-all approach is not appropriate.

In 2007, the National Bioethics Advisory Committee considered these issues in the context of consent for research participation.

The committee in its report stated: "It is of the nature of informed consent that one must consent with understanding.

"It should be self-evident that the language, occasion and manner of explanation, the level of detail offered, and the process by which the consent is taken, should all be aimed at helping the potential research participant understand what consent is being asked for."

This is equally true of patients when consent for a medical procedure is sought. The key is understanding.

The need is not necessarily for more information; it is for the patient to understand what is being proposed, why, and the associated risks and benefits.

Different patients will have different levels of understanding. It follows that there needs to be sufficient flexibility to meet the individual case. The medical practitioner needs flexibility within any framework, and I would be very sorry to see it removed.

This might better protect practitioners legally from claims by dissatisfied patients, but might not enhance patient understanding.

Indeed, they might reduce real understanding and thus prove counterproductive.

John Elliott

A version of this article appeared in the print edition of The Straits Times on October 27, 2017, with the headline 'One-size-fits-all approach not best for patient consent'. Print Edition | Subscribe