Wouter Leclercq

A review of surgical informed consent: Past, present, and future. A quest to help patients make better decisions 25 2 the risk of this happening was a mere 1:14,000, the court ruled that the surgeon should have informed the woman of the risk as she had apparently asked for this information. On the other hand, the doctor had considered this low risk not relevant. 11,20 Although not totally abandoned, the ‘‘reasonable doctor standard’’ has become a secondary standard next to the ‘‘reasonable patient standard’’ in most countries. 21 Since the 1980 Truman vs. Thomas case, information provided in an IC process must also include the risks of ‘‘not acting or postponing’’. 22 In this case, a Pap smear was refused by a woman who claimed not to know the associated risks, i.e., not detecting cancer in time for curative treatment. 7 Dutch legislators as well as governments from various other Western countries have realized that their legislation was out of date. Based on cases such as those mentioned above, several adjustments have led to the 1995 Dutch Medical Treatment Contract Act in which all elements of IC are present, including preconditions, information, and consent. Although legislation differs widely between countries, these ‘‘basic elements’’ are consistent in the Western world.