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August 1969

Patient Consent Form

Arch Otolaryngol. 1969;90(2):255. doi:10.1001/archotol.1969.00770030257033

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THE increasing risk of malpractice suits against physicians and hospitals prompts the need for a more complete patient consent form to ensure that proper disclosure has been made to the patient, and that the patient has given fully informed consent to the contemplated procedure. A special consent form has been outlined in Hospital Law Manual, under Consents, Sections 3-6, to include the following:

  1. Time of consent, to show that the patient has full use of his faculties, unaltered by drug administration or other reason.

  2. Statement of the patient's condition to be remedied.

  3. Name of the physician who will do the procedure.

  4. Description of the procedure in layman's language.

  5. Known risks and adverse consequences, described in layman's language that the patient can understand.

  6. Statement of normal risks of any procedure, including loss of blood, infection, and cardiac arrest.

  7. Statement that no guarantees are made.

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