FOR many Malaysians, medical consent is still seen as a quick administrative step—a signature on a form before an operation.
A common misconception here is some patients assume that signing the form removes all responsibility from doctors and protects hospital from any liability.
Others believe they have no real choice once the doctor offers a procedure. But informed consent is far more meaningful than that. It is a foundation of ethical medical care, a patient’s right, and a critical safeguard for both the public and healthcare professionals.
Why consent matters
It is well understood among surgeons that no operation is entirely risk free. Even routine procedures carry potential complications—bleeding, infection, anaesthetic risks, or the need for further surgery.
Informed consent ensures patients understand these possibilities before entering the operation theatre, not after something goes wrong. But more importantly, informed consent promotes trust and cooperation.
Trust is the pillar of doctor-patient relationship, and this can be achieved through good consent taking. When patients understand what condition they have, benefit and risks of each surgery, they walk into the operating theatre with confidence rather than doubt and fear.
Studies consistently show that well-informed patients experience less anxiety, better adherence to treatment and improved recovery after surgery.
Consent is not about protecting hospitals and doctors; it is about respecting patients’ autonomy, dignity, and right to make decisions about their own bodies.
Why Malaysians still sign without understanding
Even with higher medical standards, medical jargon can be confusing for many Malaysians. Words like “obstruction”, “adhesion”, or “malignant” may sound familiar but are often poorly understood.
In busy clinics, patients may hesitate to ask questions and doctors won’t have adequate time to explain them. This reflects deeper issues.
Cultural deference to doctors and other healthcare workers will enhance the view that asking questions will be viewed as impolite. Limited health literacy compounds this effect and risks the probability of poor understanding of patients towards the intended procedures.
In Malaysia, certain cultural norms are prevalent. Family-oriented decision-making can sometimes hinder patient’s autonomy. Relatives sometimes take over decisions, overriding the patient’s own wishes.
Patients should be empowered and made to know that eventually the validity of the consent lies from their own signature on the consent form and only then the surgery can proceed—not by any family members.
To sign or not to sign
In Malaysia, patients have the right to receive adequate information about their condition. They are also entitled to a clear explanation of any proposed treatment, including the planned procedure and its common possible complications, before it begins.
Doctors are legally required to inform his patient who can understand and appreciate such information of the risks involved in any proposed treatment. This allows patient to make informed decisions whether to proceed with the proposed treatment.
Based on Provision 2 of the Malaysian Medical Council (MMC) 2016 guidelines, obtaining a patient’s consent is an important component of good medical practice and carries specific legal requirements.
Failure to do so may result in a disciplinary inquiry for transgression of ethical professional codes and/or legal action for assault and battery instituted against the medical practitioner or the medical institution.
It is advisable that doctors do take some time to explain the procedure in detail to patients. A general consent form is insufficient if patient is not informed of relevant risks of the procedure.
Strengthening consent
Malaysia’s healthcare landscape is evolving rapidly. With more complex procedures, increasing chronic disease and cancer diagnosis and rising awareness of patient rights, consent must evolve too.
Doctors can use simpler language, allow adequate time for discussion and subsequently document conversation clearly.
To enhance understanding, doctors can provide printed materials and visuals. At the same time, doctors should enhance their communication skills, become active listener and provide empathy.
Under Section 47(3) of the Private Healthcare Facilities and Services Regulations 2006, a patient’s consent must generally be given in writing. However, if a standard consent form is not used, the healthcare provider must clearly record in the patient’s medical notes that the patient was properly informed about the procedure and had agreed to it.
Having this information in writing is important because it clearly sets out responsibilities and helps protect both doctors and patients if something goes wrong during the procedure, such as complications during the surgery or negligence.
Dr Nabil Mohammad Azmi is a surgeon and lecturer at the Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia and Redza Zakaria is the Deputy Head Unit of Maritime Law, Policy and Governance at the Institute of Ocean Earth and Sciences and senior lecturer at the Faculty of Law, Universiti Malaya.
The views expressed are solely of the author and do not necessarily reflect those of MMKtT.
- Focus Malaysia.
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