Informed Consent

This unique exploration examines informed consent as a social construct within surgical practice. Drawing on 30 years of surgical experience, the author traces consent's evolution from informal agreements to formalised processes, analysing its philosophical foundations and legal history within the NHS. The book addresses growing litigation concerns while questioning why patients readily trust surgeons they've just met. It explores specific challenges to obtaining truly informed consent, including cultural diversity and health literacy barriers. This unprecedented work illuminates how consent has developed into its current form, offering valuable insights for practitioners.

Key Features:

• Traces the surgical consent journey from ancient practices to modern protocols, revealing how patient autonomy has transformed medical decision-making over centuries
• Offers rare firsthand observations on the paradox of patient trust in surgical settings, informed by three decades of clinical experience and real-world case studies
• Examines critical obstacles to meaningful informed consent, including healthcare illiteracy and cross-cultural challenges, with practical approaches for modern healthcare environments

Chapter I Craft Surgery. From Babylon to London and Salerno. Medieval Craft Surgery. The Royal College of Surgeons of England Chapter 2 Contemporary surgery 1950s to the present. Current litigation and compensation Chapter 3 A Taste of the Legal Side. A brief historical review. Common Law. Slater v Baker and Stapleton Chapter 4 History of and Current Consent Forms (2025). Nuremberg Code. NHS created. GMC and Royal College of Surgeons Guidelines Chapter 5 The legal position of informed consent in practice. Tort Law and other definitions. Bolam, Bolitho, Sidaway, Spencer and Montgomery Chapter 6 Influences on Consent. Information. Shared Decision Making, Healthcare Literacy. Procedure Specific Consent and e-Consent Chapter 7 Surgical Ethics. From Humble Submission to Surgery and on to Autonomy of the Surgical Patient. Social Contract. Social Construct. Bioethics. Principlism. Veatch and O’Neill Chapter 8 Research. The development of Consent Forms. Hospital web page information for patients. A survey of volunteer research participants. Chapter 9 Discussion. Trust and Dissatisfaction. Some conclusions and into the future

Stephen Chadwick is a retired consultant surgeon. His surgical consultant posts were in Harrow, London, at Northwick Park in General Surgery including emergency surgery and St Marks in specialist colorectal surgery. In 1991 he introduced laparoscopic general surgery to Northwick Park Hospital. He retains an academic interest as an Honorary Professor at the University of West London and at Brunel University, London as an Honorary Research Assistant. He was an Honorary Senior Lecturer at Imperial College, London. He has worked, both in clinical practice and in academia, in many parts of the world and for a time, after he left his NHS practice, was a General Surgeon including obstetrics, available for an emergency call out with an NGO. His research interests are wide from host defence mechanisms following major surgery to whether one can distinguish a single malt from a blended whisky. From the earliest times of his career, he has been interested in the history of medieval surgery and the technology available to those who practised surgery. He has some experience of medicolegal practice but never fully embraced it. He enjoyed student life at the Middlesex Hospital Medical School and still remains in contact with many of his peer group. He meets up at least twice a year with practising and retired surgical colleagues from around the country. He also meets with former colleagues and chiefs from St Mary’s Hospital in Paddington where he undertook his senior registrar surgical training. In his spare time, he helps to look after rescue horses who have in their past experienced unnecessary hardship.