Informed consent in anaesthesiology

Any interference with the physical integrity of another person, including medical interventions, constitutes a personal injury according to the Criminal Code. Therefore, in the sense of the right of self-determination of the patient, every physician has to obtain informed consent from the patient before an intervention. Without an informed consent, there is no legal certainty for the attending physician in cases of any claims. This is even more important once alternative methods would have been possible for the performed intervention or if the procedure even entails a complication. In addition to the important medicolegal aspects of patient informed consents (who should inform, at what time and to what extent should informed consent being employed, about which risks should one inform, how to deal with language barriers and special patient groups, and how to document obtainment of informed consent), the topics of the doctor-patient relationship, the nocebo and placebo effect of medical communication, the unconscious and conscious transference reactions as well as possibilities for further medical education in the field of patient consent are also presented. Special challenges for a bilaterally (i.e. the doctor's and the patient's perspective) well perceived medical communication are usually shortage of time for the premedication and consent discussion, inadequate office space in which such a conversation takes place and the problem of how to balance between explaining the risks on the one hand and uncertainty or even frightening the patient by naming possible or real individual-specific risks on the other hand during the information discussion.