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Invited Critique
Jan 2012

Informed Consent, Trainees, and the Cost of Full DisclosureComment on “Training Surgeons and the Informed Consent Process: Routine Disclosure of Trainee Participation and Its Effect on Patient Willingness and Consent Rates”

Author Affiliations

Author Affiliation: Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.

Arch Surg. 2012;147(1):62. doi:10.1001/archsurg.2011.236

Informed consent is the process of communication between a patient and a physician that results in the patient's authorization or agreement to undergo a specific medical intervention. As a shared decision, it is a critical component in the relationship between surgeons and their patients. Central to informed consent is the idea of autonomy, whereby patients make their own decisions after the physician has detailed the nature of the treatment, its possible alternatives, and its potential risks and benefits. As part of this discussion, it seems obvious that patients would want the extent of involvement of surgical trainees during a surgical procedure to be disclosed, but current ethical and legal requirements for informed consent for care by trainees have not been well elucidated. According to the American Medical Association, the physician is obligated to disclose and to discuss the patient's diagnosis; the nature and purpose of the proposed procedure; and the associated risks and potential benefits of the procedure, its possible alternatives, and of foregoing the procedure. To my knowledge, no specific requirement or guidance exists regarding disclosure of the extent of participation of surgical trainees.

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