BY DAVID CHEUNG

The advent of COVID-19 will continue to impose major adaptations in how we as surgeons practise and offer elective surgery going forward. In addition to how we try to adapt to make our practice as safe for the patient and our teams as safe as possible, we also have a duty to inform our patients properly to allow them to make an informed choice about their management. Since the landmark medicolegal case of 2015 (Montgomery vs. Lanarkshire Health Board) we have been encouraged to inform our patients of all significant risks and the materiality of these risks for each patient. As such, our consent processes now and their documentation have become much more explicit; largely to inform the patient systematically of risk but also to document from a medicolegal perspective this process. COVID-19 introduces extra considerations for patients undergoing elective surgery that must be discussed in the consent process including the option of deferral / cancellation of surgery, the possibility of disruption of care due to unforeseen circumstances, the increased risk of a patient contracting COVID-19 and how this may impact on them, their health, their postoperative recovery and that of their household. Finally, our consent processes must also consider the novelty of this disease and how there may be unknown risks and complications resulting from COVID-19 infection that we just do not know about yet.  As our knowledge of this disease evolves and with the restart of elective operations, then so too will our consent process. For the past few months, the author and the Midland Oculoplastic Surgery Society, have been working on a consent proforma to act as guidance for our members to improve the rigour of this changing process. We hope very much that it will be as useful for PMFA readers as it has been for our members.

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David Cheung, Consultant Ophthalmic and Oculoplastic Surgeon specialising in Cosmetic and Functional Lid, Lacrimal and Orbital Surgery, Birmingham.