Patients would then be placed on a common waiting list within the unit. At time of admission, patients would be allocated to a surgeon at random some attempt could be made to match patients with the original surgeon. It could conceivably be extended to regional or even national level. These state that consent is a process which begins well in advance of the operation patients should be allowed time for reflection. Ideally consent should be taken in outpatients by the surgeon who is going to undertake the procedure.
Doctors can no longer treat patients in a patriarchal manner.
Patients now rightly expect to participate in the decision-making process about their treatment. Even in the relatively homogeneous coronary surgery patient group, informed consent for an operation is essentially a contract between patient and surgeon. Without this background, truly informed consent cannot take place. It can be clearly seen that common waiting lists of any type are not compatible with the above principles. With the more straight forward, lower risk cases now undergoing angioplasty rather than surgery, it is the higher risk patients who are being referred for surgery and thus more potential for problems.