Pre-Operative Information: A New Chimeria for Surgeon?

The chimera refers to an imaginary monster with several heads and also corresponds to an idea unrelated to reality. The preoperative information of our patients isn’t a utopia? The scientific literature shows that patients, while overestimating their abilities, retain only about 30% of the information received. The surgeon must be able to provide proof, in case of legal proceedings, that he has informed his patient. The lack of information is, in fact, likely to lead to the notion of loss of opportunity and moral harm of non-preparation. Although not required by law, the written papers have imposed itself on a daily basis and in particular because it is perceived as evidence. Consultation letter thus became a master piece along with the signed informed consent. The use of fact sheets, which complement oral information, tends to become widespread. In conclusion we see the information is far from being an obvious topic. Patients assimilate information with bias and difficulty, but the surgeon nevertheless has an obligation to provide proof that he has provided this information. The task is therefore difficult for us surgeon. The complete information of the patient often remains a utopia. Indeed, while it is sometimes difficult to inform patients, it is even more difficult to ensure that they have understood correctly. We must therefore not give in to the pressure of this chimera and be careful not to slip into a “defensive surgery” consisting of taking refuge, in particular, behind writings which are certainly medico-legal evidence but which do not constitute the basis of the relationship between the surgeon and his patient. We must keep the fundamental principles that have been taught to us and maintain the exercise of our Art, according to ethical values, while fulfilling our legal obligations, and in particular, by the traceability of this information in a complete medical record.