How informed need be informed consent?

Abstract

Dr C. Lever is a pioneer in endovascular infrarenal aneurysmectomy, with some of the best results published in the literature. He attempted an endovascular stent in an octogenarian that required an acute open repair. The procedure was touch-and-go and the postoperative course a train wreck, with multiple organ dysfunction syndrome. After steadily deteriorating, the patient died. The son has filed a lawsuit claiming Dr Lever did not specify that a standard procedure might need to be done as an emergency. Dr Lever usually indicates an open procedure might be necessary, but the resident did not include whether or not Dr Lever did so in the informed consent note. Regarding technical details in the informed consent note: A. Always include operative details that will increase the risk, no matter how rare. B. Operative details are not necessary. C. Complications are the only necessary important components of informed consent documentation. D. As long as you postoperatively document what happened in the OR, you are legally and ethically all right. E. Every factor that could influence the patient's decision must be mentioned and then adequately documented.