State hospital consent forms are to be brought up to date with developments in the medical field, The Times has learned.

This means they will become more elaborate, depending on the different surgical procedure to be carried out instead of consisting, as they do now, of a mere couple of lines that apply to every type of surgery.

This generic consent form was recently criticised in a European survey carried out by the Active Citizens Network and contributed to lowering Malta’s EU ranking in terms of patients’ rights.

At present, patients at Mater Dei Hospital are asked to sign a paper stating: “I, the undersigned, hereby agree to permit the authorities to carry out whatever operation/s, including anaesthesia (local or general) and blood transfusion they may consider necessary in my interests.”

This is not usually co-signed by the surgeon who carries out the operation, and it has been argued that it does not give the patient enough information to be able to give an informed consent.

However, doctors who were contacted were quick to point out that although the form may be somewhat “simplistic”, patients give verbal consent and are given information about the procedure at the time their surgery is booked, usually during an outpatient clinic.

“I tend to agree that our hospital consent forms are simplistic. However, that is only part of the story,” consultant gynaecologist Mark Formosa said.

He added that when a patient was advised to undergo an operation the surgeon explained the reasons behind it, the procedure and possible complications.

“Even though the house officer may get the actual signature, when the decision is taken we don’t just tell them they need an operation but explain the whole process,” he said.

A case in point, he added, was during a hysterectomy, when the advantages and disadvantages of retaining the ovaries are discussed with the patient before a decision is taken.

His views were backed up by general surgery consultant Joe Debono. “Whoever carries out the operation gets the verbal consent and we try to get this signed in outpatients. But what happens is that the form gets lost by the time the patient gets to the operation,” he said.

Apart from being an issue with patients ’ rights, the problem with a simplistic form is that it arguably creates a potentially large medico-legal loophole. Doctors pointed out that while some lawyers say the paper is valid in court, others say it has little or no value during legal proceedings.

When contacted by this newspaper, the state hospital’s legal advisor Brigitte Gafà said the present consent form was valid in court.

Current practice, she said, was that the doctor performing the procedure gave the patient information about the surgery to be undertaken. The actual form is signed a day before the oper-ation and may be signed by a -doctor other than the one performing the procedure. The important thing is that the doctor who signs it with the patient knows what the procedure is all about, Dr Gafà pointed out.

However, the government was in the process of revisiting this form to bring it up to date with developments in the field, she said.

Doctors also pointed out there were information booklets on the more common procedures that were given to patients before an operation.

What patients need to know

In the process of obtaining patients’ consent, doctors should point out the common complications which occur in about one per cent of cases in that particular procedure, according to general surgery consultant Joe Debono.

Consent involves receiving information about the oper-ation itself, any alternatives, and the advantages and disadvantages of the chosen oper-ation over the alternatives.

Apart from the common complications, the potentially serious complications, even if uncommon, should be pointed out to the patient, he said.