Consent for keyhole gallbladder surgery
AMC Clinical practice station
Ethics, consent & capacity · 2 min to read · 8 min to perform
Explain the procedure, its risks and the alternatives, check his understanding and answer his questions.
Peter AndersonG'day doctor. They said it's only keyhole surgery, so it's pretty simple, right?
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You are a surgical resident in a pre-admission clinic. Mr Peter Anderson, aged 64, is booked for laparoscopic removal of his gallbladder for symptomatic gallstones. His surgeon has asked you to discuss the operation with him and obtain his informed consent. He is alone. Explain the procedure, its risks and the alternatives, check his understanding and answer his questions. Do not complete any forms; the discussion is what is being assessed. The examiner will not take part in the conversation.
What this station tests
- Informed consent needs the procedure, material risks, alternatives and the option of doing nothing, in plain language. Under Rogers v Whitaker, a risk is material if this patient, or a reasonable person in his position, would care about it.
- Ask what the patient already believes; "keyhole means no risk" is a common misconception to correct kindly.
- Never pressure a patient because of waiting lists; voluntariness is part of valid consent.
- Anticoagulants need a specific plan from the treating teams; do not tell the patient to stop them yourself.
- Use teach-back and document the discussion.
Sources for the clinical content
- Australian Commission on Safety and Quality in Health Care: Making informed choices (informed consent)
- healthdirect: Cholecystectomy (gallbladder removal)
- Rogers v Whitaker [1992] HCA 58 (AustLII)
- Medical Board of Australia: Good medical practice, a code of conduct for doctors in Australia
An original practice scenario with invented patients. Not an exam question.