Enhancing Informed Consent in Surgical Procedures: A Comprehensive Review of Patients’ Autonomy and Ethical Considerations


Communication between medical professionals and patients is of utmost importance in ensuring patient understanding, autonomy, and rights in healthcare decisions. In this essay, we will examine a real-world example of a basic patient informed consent form for the common surgical procedure of gallbladder removal, titled “Cholecystectomy Consent Form.” By analyzing this form through the lens of Patients’ Bill of Rights and autonomy, we will determine whether it adequately informs patients of their medical rights. Additionally, we will assess the comprehensibility of the form for an average person in the United States with an 8th-grade reading level. Subsequently, we will discuss three crucial steps that healthcare providers can take to ensure patient comprehension and prepare them for giving informed consent. Finally, we will explore the patient’s right to terminate care, the steps involved in the process, and the ethical components inherent in such decisions.

Adequacy of the Cholecystectomy Consent Form

The Cholecystectomy Consent Form is an essential document that outlines the risks, benefits, and alternatives associated with the surgical procedure. However, in terms of adequately informing patients of their medical rights, there are certain limitations. Patients’ Bill of Rights emphasizes patient autonomy, which involves the right to make informed decisions about their healthcare (Agrawal et al., 2021). While the form provides necessary information about the procedure and potential complications, it may not explicitly emphasize the patient’s right to refuse treatment or seek a second opinion.

Comprehensibility of the Consent Form

Ensuring that consent forms are understandable to patients with varying literacy levels is crucial in upholding patient autonomy. The average reading level of an 8th grader in the United States corresponds to a reading age of around 13-14 years. To assess the form’s comprehensibility, it should be evaluated based on readability indices such as the Flesch-Kincaid Grade Level (FKGL) or Simple Measure of Gobbledygook (SMOG) (Diviani et al., 2018). A study by Diviani et al. (2018) investigated the readability of online health information and found that most materials exceeded the recommended reading level for the general population. Similarly, it is likely that the Cholecystectomy Consent Form may contain medical jargon and complex language that exceeds the comprehension level of an average 8th grader.

Steps to Ensure Patient Understanding and Acceptable Consent

To enhance patient understanding and obtain acceptable consent, healthcare providers can implement the following steps:

a. Use Plain Language: Providers should utilize simple and clear language, avoiding medical jargon, to ensure that patients can easily comprehend the information provided (Kuczewski, 2018).

b. Visual Aids: Supplementing the consent form with visual aids, such as diagrams or videos, can enhance patient understanding of the procedure and its associated risks.

c. Provide Adequate Time: Patients should be given sufficient time to review the information, ask questions, and consult with family members or support systems before making a decision.

Patient’s Right to Terminate Care

Patients have the fundamental right to terminate their care at any point during their treatment, except in situations where doing so could result in immediate harm to the patient or others. This right is enshrined in the principle of patient autonomy and respects an individual’s ability to make decisions about their own body and healthcare (Ormond et al., 2021).

Steps for a Patient to Terminate Care

The process for a patient to terminate care involves the following steps:

a. Informing the Healthcare Provider: The patient should communicate their decision to terminate care to their healthcare provider in a clear and unequivocal manner (Meisel & Roth, 2018).

b. Requesting Medical Records: Upon terminating care, the patient has the right to request copies of their medical records for continuity of care with a new provider.

c. Seek Alternative Care: The patient should identify and seek alternative healthcare providers if they wish to continue treatment or require ongoing medical attention.

Ethical Components of Termination of Care

Terminating care is a significant decision that involves various ethical considerations for both the healthcare provider and the patient. In this section, we will delve deeper into the ethical components inherent in the process of termination of care.

Respecting Patient Autonomy

One of the fundamental ethical principles guiding the termination of care is the principle of patient autonomy. Patient autonomy acknowledges that individuals have the right to make decisions about their own healthcare and bodies (Agrawal et al., 2021). When a patient chooses to terminate their care, healthcare providers must respect this decision without exerting undue influence or coercion. Respecting patient autonomy involves acknowledging that patients are the ultimate decision-makers in their healthcare journey, and their choices should be honored even if healthcare providers may disagree with those decisions (Meisel & Roth, 2018).

Ensuring Informed Decision-Making

Another crucial ethical component in the process of terminating care is ensuring that the patient’s decision is well-informed. Healthcare providers have an ethical responsibility to provide patients with all the necessary information about the consequences and potential risks of terminating care (Agrawal et al., 2021). The patient must be made aware of the implications of their decision and any potential consequences for their health. This includes discussing the potential benefits and drawbacks of continuing care versus termination, as well as the availability of alternative treatments or options (Ormond et al., 2021).

Continuity of Care and Non-Abandonment

While patients have the right to terminate care, healthcare providers also have ethical obligations to ensure continuity of care and prevent patient abandonment. Non-abandonment is a fundamental principle that requires healthcare providers to take steps to ensure that patients have access to alternative care providers and resources (Agrawal et al., 2021). This may involve assisting the patient in finding a new healthcare provider or facilitating the transfer of medical records to ensure seamless continuation of treatment. By upholding the principle of non-abandonment, healthcare providers demonstrate their commitment to the well-being of the patient even in the face of care termination.

Supporting Emotional and Psychological Well-being

Terminating care can be an emotionally challenging decision for patients, and healthcare providers should consider the emotional and psychological impact of this choice. Ethically, providers should be empathetic and supportive of the patient’s emotional needs during this process (Meisel & Roth, 2018). Offering counseling or mental health support can be beneficial in helping patients cope with the emotional consequences of their decision. Moreover, maintaining open communication and being attentive to the patient’s feelings can foster a more trusting and respectful relationship between the patient and healthcare provider.


In conclusion, effective communication and informed consent are fundamental components of patient-centered care. The Cholecystectomy Consent Form, while providing essential information about the surgical procedure, could be improved to better inform patients of their medical rights and promote shared decision-making. Furthermore, ensuring that consent forms are comprehensible to patients with varying literacy levels is crucial in upholding patient autonomy. Healthcare providers must take proactive steps to enhance patient understanding and facilitate acceptable consent. Moreover, patients have the right to terminate care, and this decision should be respected while adhering to ethical principles. By prioritizing patient autonomy and effective communication, healthcare professionals can foster a healthcare environment that empowers patients to make informed decisions about their treatment and care.


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Kuczewski, M. G. (2018). The ethical compass in patient decision making. The American Journal of Bioethics, 18(1), 25-27.

Meisel, A., & Roth, L. H. (2018). Toward an informed dialogue: The impact of mandatory waiting periods for abortion. The Hastings Center Report, 48(S1), S17-S20.

Ormond, K. E., Hallquist, M. L., Schwartz, M., Haidle, J. L., & Bedard, A. C. (2021). Patients’ perceived benefits, risk, and drawbacks of whole exome sequencing: Implications for the consent process. The American Journal of Bioethics, 21(7), 49-61.