Consent: assessing and communicating risk

The process of consent constitutes a complex and challenging area of modern medical practice for which many bodies have produced guidance. Consent is influenced further by statutory regulation, which continues to evolve over time. To provide truly informed consent the risks of any intervention need to be established for that particular patient. These are often extrapolated from samples of populations and then need to be tailored to the individual. We must be aware of the variations between surgical teams, over time, and importantly between patients. Scoring systems have been developed to help predict the risks of certain outcomes for groups of patients. Patients and doctors will interpret these risks subjectively. Risk perception biases can be minimized by the methods that we employ to communicate these risks. The use of both descriptive and numerical terms is recommended. More recently decision aids involving leaflets, diagrams, videos and other media have been developed to help patients understand the risks more fully.