A patient signed consent for parotidectomy six weeks ago. On the morning of surgery they appear uncertain and ask about facial-nerve risk. What should happen?
Consent is an ongoing process. The surgeon should check that circumstances and wishes remain unchanged, answer questions and allow a free decision; a previously signed form does not compel surgery.
A. Proceed because the form is legally binding: Consent can be withdrawn and validity depends on continuing understanding and voluntariness.
B. Ask nursing staff to reassure the patient while anaesthesia begins: Material surgical questions should be addressed by someone with appropriate knowledge before sedation.
C. Obtain another signature without discussion: A second signature does not remedy inadequate decision support.
D. Pause and revisit the decision, risks and alternatives before proceeding: Consent is an ongoing process. The surgeon should check that circumstances and wishes remain unchanged, answer questions and allow a free decision; a previously signed form does not compel surgery.
E. Cancel permanently without exploring the concern: The immediate priority is a genuine conversation; postponement may be needed but is not automatic.
If the patient lacked decision-making capacity, treatment would require a capacity-specific best-interests process rather than proxy signature alone.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for local policy and specialist judgement.
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