The following statement was approved by the College's Board
of Regents in February 1996.
- The surgeon is responsible for confirming the diagnosis for
which surgical care is proposed. This responsibility should include
the surgeon's personal review of all pertinent aspects of the
patient's case. Appropriate consultation should be requested,
- The surgeon is responsible for presenting to the patient
the range of options available for the patient's appropriate
management, including the surgeon's recommendations and rationale
for a specific approach to treatment. Choice of a specific treatment
must ultimately be up to the patient; in the event that the patient
is not legally competent to express a choice, for whatever reason,
the decision of the patient's appropriately appointed surrogate
must be substituted for that of the patient.
- The surgeon is responsible for obtaining informed consent
from the patient, or, if necessary, from the patient's surrogate,
after discussion of treatment. The surgeon is responsible for
conducting the discussion and for documenting that it took place.
The surgeon need not personally obtain the patient's signature
on the consent form.
- The surgeon is responsible for the proper preoperative preparation
of the patient. Minimizing the risk of operation, while providing
maximal opportunity for a satisfactory outcome, requires a full
appreciation by the surgeon of the patient's condition. Achieving
optimal preoperative preparation of the patient will frequently
require consultation with other physicians; however, the responsibility
for attaining this goal rests with the surgeon.
- The surgeon is responsible for the safe and competent performance
of the operation. Part of this responsibility includes planning
for the operation with the anesthesiologist in order to ensure
anesthesia that is best for the patient.
- The surgeon is responsible for postoperative care of the
patient. This responsibility includes personal participation
in and direction of postoperative care, including the management
of postoperative complications. The best interest of the patient
is thus optimally served because of the surgeon's comprehensive
knowledge of the patient's disease and surgical management. Even
when some aspects of postoperative care may be best delegated
to others, the surgeon must maintain an essential coordinating
role. Should complications of operation develop, the surgeon
is best able to detect them and to provide or coordinate timely
and appropriate therapy. This responsibility extends through
the period of convalescence until the residual effects of the
surgical procedure are minimal, and the risk of complications
of the operation is predictably small. The surgeon is responsible
for determining when the patient should be discharged from the
- The surgeon is responsible for disclosing to the patient
information related to the conduct of the operation, operative
and pathologic findings, the procedure performed, and the expected
- When the time comes that the surgeon will no longer be involved in follow-up of the patient, he or she is responsible for ensuring appropriate long-term follow-up for continuing problems associated with the patient's surgical care. All information necessary to provide care for those problems should be made available.
Reprinted from Bulletin of the American College of Surgeons
Vol. 81, No. 9, Page 39, September 1996