Background: Pre-operative INFORMED CONSENT is an important aspect of surgery, yet there has been no formal training regarding it in Pakistan. This study was done to assess the preoperative INFORMED CONSENT practice.Methods: After taking INFORMED permission, a questionnaire was filled in during an interview with 350 patients, who have undergone elective surgical procedures under routine practice conditions from July to October 2010. All the patients were asked a set of standard questions which related to the information they were provided before the operation as a part of standard INFORMED CONSENT practice.Results: Most i.e.307 (87.7%) patients were INFORMED about their condition but very few 12 (3.4%) were briefed regarding complications. Only 17 (4.9%) patients said they knew about the risks and complications of proposed anesthesia. One hundred thirty-eight (39.4%) patients said that they were allowed to ask questions while giving CONSENT. Most of the time 196 (56%) CONSENT was taken one day before surgery but in few 2 (0.6%) instances it was taken on the morning of surgery and on operation table in some cases 3 (0.9%) as reported by patients. The CONSENT form was signed by the patients themselves in only 204 (58.3%) cases and by their relatives in the rest. About half the number of patients 171 (48.9%) interviewed were satisfied from the information they received as INFORMED CONSENT process.Conclusion: This study highlights the poor quality of patient knowledge about surgical procedures and the inadequate information provided.

Introduction: Use of INFORMED medical CONSENT prior to therapy is not a new concept and has been performed for a long time. Yet in recent years it has acquired a critical importance due to the widely increased complexity of medical procedures. Informing the patient about his chances of benefiting from a given therapeutic procedure and the likelihood of its antecedent risks and side effects is an inseparable and essential component of standard patient management. An INFORMED CONSENT will be meaningless without such data. INFORMED CONSENT plays key roles in both medical ethics and patient rights, and its proper application prior to diagnostic or therapeutic procedures typically will yield better results. It is therefore imperative that the patient or his legal guardian or surrogate fully understand and approve the therapy under consideration. Understanding and approving are equally important in this process and when properly applied in an ethical manner, can hasten the process of patient recovery. Medical personnel are thus obliged to fully reveal the patients all information about their illness as well as the therapeutic options available to them. Failure to do so will encumber legal ramifications.

Context: This article discusses the paradigm shift in health care and bioethics from the concept of INFORMED CONSENT to INFORMED choice. Evidence Acquisition: INFORMED CONSENT is linked to the concept of respect for autonomy-one of the four pillars of bioethics. This concept requires health care givers to share information with patients so they can make appropriate health care decisions. However, the concept of INFORMED CONSENT has been critiqued as being paternalistic and not attentive to the complexities of modern health care decisions.Results: As a result of a paradigm shift in health care and ethics, favoring autonomy over other principles-INFORMED CONSENT evolved to the more patient-centered concept of INFORMED choice. Even so, feminist bioethicists critique the mainstream model of INFORMED choice as being inattentive to inherent power dynamics within health care and society which may influence decision making. Drawing on the model of midwifery in Canada, this paper outlines an approach to health care that incorporates feminist definitions of INFORMED choice.Conclusions: This paper reviews the necessary criteria for INFORMED choice to be attentive to the individual needs of women. Using the model of midwifery in Canada as an example, this paper demonstrates how feminist approaches to INFORMED choice should be preferred in modern health care settings.

INFORMED CONSENT is considered the most important step in clinical interventions. According to the Beauchamp’s definition the CONSENT is: “...an autonomous act by a patient or research subject to expressly permit a professional person to perform a medical action on the patient or to include a person in a research project...”. This definition is widely accepted, but recently, the position of the CONSENT is changed to a legal document which is necessary to protect the physician or researcher. For obtaining a good CONSENT, it must be ensured that the patient understands the nature of their condition and the risks and benefits of the treatment procedure and its alternatives, and agrees to it voluntarily. In Iran due to current penal code, the CONSENT is in controversy. There are 3 expressions related to the INFORMED CONSENT in penal code of Iran: 1. Permission "Persian: EZN" article 318 of penal code, 2. CONSENT "Persian: REZAYAT" article 59 of penal code and 3. Disculpation "Persian: BARAAT" article 60 of penal code.It seems that all the 3 articles can be summarized in "INFORMED CONSENT" with the following conditions: 1. Full information about the disease and treatment procedure including duration, possible pain, complication and … which should be presented both verbally and written in the CONSENT.2. INFORMED CONSENT is not a contract but it is the process of making decision between patient and physician which means "the patient knows what is going on".3. INFORMED CONSENT cannot disculpate any body; the malpractice can be evaluated if the patient claims. If the physician makes a mistake, he will be punished regardless of presence of an INFORMED CONSENT signed by the patient.4. There is no need for husband CONSENT in the case of wife's treatment, but as having a baby cannot be considered as "a treatment", the CONSENT for assisted reproduction must be given by both.5. INFORMED CONSENT can be taken back in any time, but it seems that the CONSENT in assisted reproduction can be taken back just by wife or husband.6. According to the law, the CONSENT for therapeutic abortion can be given only by the pregnant woman and there is no need for the husband's CONSENT. This includes the CONSENT for pregnancy termination.7. One of the most important issues in INFORMED CONSENT is the patient's capacity. Before getting the CONSENT the physician must be confident that the patient understands the situation and can communicate with the doctor. As using assisted reproductive technique is an intentional act for a couple, so, the capacity is not an issue in this regard. Therefore, no patient without capacity can participate in assisted reproduction programs.