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so informed consent is one of the fundamental good practices or pillars or cornerstone of a good and ethical hair restoration surgery practice like any other medical practice the presence of an informed consent before a surgical procedure is legally binding on the medical establishment where the procedure is going to be undertaken in india it forms a misconduct under the indian medical council act of 2012 that deals with professional ethics etiquette and conduct however law does not provide a standard form for the patient to fill the standard form for the patient to fill has to be consonant with the specialty it should relate to the procedure being undertaken it should be so modulated to suit the purpose of the patient since no two patients are similar therefore no two consent forms can be similar every patient has different objectives every patient has different aims goals and every patient has to be guided in a particular manner to follow various methodology of treatment as best suits his condition and especially so in hair transplant which is a cosmetic surgery procedure so what is a good consent a good consent should be a discussion a formal discussion it could be online preceding the consent in written form through emails through messages through social media it should deal with the boldness of the patient the level of boldness of the patient it should deal with the various modalities of cure available for his specific condition it should go through all the modalities best suited for the patient's own condition it should not be general in nature it should be custom cut to suit the patient's condition also it should inform the patient about the best modality of treatment for this given condition and also the second best and perhaps the third best treatment suited to the patient's condition it should list all the complications all the possible side effects that can occur however remote not to scare the patient but to inform the patient that this is a possibility for hair transplant is not a parlor procedure it is a surgical procedure which is carried out under anesthesia and anesthesia various drugs have their own risks so this has to be informed to the patient so the patient can make an informed decision to whether go in for hair transplant or to consider other modalities of treatment in most reputed clinics and informed consent is not an instrument to be used by the clinic as a shield to protect against likely side effects against likely poor growth poor result dissatisfaction by the patient and turn around and tell the patient that see i told you so nor should it be a cover-up for operating on a patient who is otherwise not fit for surgery thinking that if i don't operate on this patient someone else will though these acts of expediency acts of commercial intent acts of commercial mindset may suit the clinic in the short term for financial gains but in the larger scheme of things in the long term it is like the clinic committing harakiri a recipe of disaster for this medical practice which engages in such maneuvers a consent should be only a conscience keeper between the patient and the doctor to maintain a cordial patient doctor relationship at all times the patient keeping trust and faith in the doctor and the doctor taking full responsibility if the eventuality of a poor result occurs so a consent and informed consent should be exhaustive nothing should be left to conjecture it should cover all the aspects of hair transplant fully informing the patient in the language he understands most so that he is fully aware of what he is going into for if it wasn't for a informed consent a consent as a conscience keeper a document as an agreement between the patient and the doctor if it did not exist the patient may one day after many years of his balding turn back and say that i never knew that my balding was ever evolving if i knew that i would one day run out of grafts and i would one day become so bold that the hair transplant that i did many years before would become an embarrassment because it would not cover the whole blood area i would not have gone in for this procedure or a doctor can turn back and say that he is not responsible for a poor growth so the purpose of an informed consent is to keep the interest of both the parties in mind before a surgical procedure is begun so an ideal consent should cover in the field of hair restoration surgery the particular condition of the patient that is the grade of baldness the patient's donor area whether it will be sufficient in future to cover the patient's objectives and goals as the boldness progresses whether hair transplant is the right modality of treatment for this given patient what are the other modalities of treatment available to the patient it should cover all possible complications all possible side effects it should cover all shortcomings of the procedure and most importantly it should be explained to the client in layman's language in simple language and if the patient is illiterate or if the patient has a body image disorder he's desperate he will sign anything the consent should be counter-signed by the patient's relative or the patient's friend who has come as an attendant along with him the whole spirit of informed consent is to give all information possible for a patient given his particular situation so that he could process that information over a period of time without any question without any force without any compelling commercial lure from the from the doctor or the clinic so it should give the patient due time to use his mind to do more research and see if this form of treatment will best suit his goals and objectives and whether he can take the risk however little or minor the chances of something going wrong might be whether he is able to take the risk of going in for the procedure so this is one of the pillars of good clinical practice keeping the patient informed giving him time for research and giving him material that would facilitate him to make an informed consent without any force without any question from the clinic in various forms the consent document that the patient is going to sign it should be freely accessible to the patient before he comes for a practice before he comes for his hair transplant it should not come as a shock or a surprise to him when he's travelled all the way for a hair transplant and there's no going back well there is an element of coercion in that as far as we are concerned we have our consent on our website which a patient can easily download the link is sent to him about a week before the hair transplant procedure and he's supposed to download it and sign it and bring it along with him when he comes for the hair transplant procedure also we would like to have the patient sign a new consent or an updated consent on the day of the procedure before he is given any sedative if he is required to be given a sedative so that he is awake and he's fully aware of what he's signing he's fully aware of what he's going into because the day before the hair transplant is the final consultation with the patient and in most cases this was the only consultation in person with the patient because many patients approach the doctor online and most of the consultation that takes place nowadays is on skype on whatsapp on email and so many other modalities available today through social media and various online platforms so when the doctor sees the patient that is the time the doctor can make a more accurate decision and a more accurate acceptance of that decision by the patient only this will ensure a proper informed consent which is legally binding or which is legally appropriate so when we do a consultation with the patient the day before the procedure it gives him a lot of time to rethink over the modalities available to him over his hairline design over how much area to cover over whether he has to do certain areas now or he can leave them for future so these decisions can only be made when you do a consultation in per these sort of decisions cannot be done online because online consultations do not have that human touch which a consultation in the clinic in person will have so there's a high chance that over the period of 12 hours that the patient has gone to his hotel room or to his room at home he might rethink the whole procedure rethink very seriously about what is right for him and what is not what meets his goals and objectives and to recalibrate his expectations from a hair transplant to make them rational enough so that they meet his future goals his future objectives and what he expects from the hair transplant that is going into and the morning of the surgery many patients would like to tweak the hairline a bit or to tell the doctor to add more grafts or lesser grafts or the patient might decide that he will leave the crown and he will come back later for the crown and better utilize the grafts elsewhere especially if his he if he is grade 5 grade 6 grade 7 extensive bond so these all decisions may change after an in-person consultation so therefore the discussion on the morning of the procedure before the patient is sedated is the most important discussion and therefore on the morning of the procedure we take a consent if there's an old consent we revalidate it and take fresh signatures and we counter sign the form ourselves one copy lies of the patient and one copy with the clinic so this is about informed consent as far as patient confidentiality is concerned it's a very big thing patients who who have a great result are so happy with the result that they as a form of gratitude to the clinic they send the pictures and they allow the clinic to use the pictures on various platforms many patients themselves will upload because they want the whole world to know what a miraculous result they have had but that is the patient's prerogative it is not the clinic's prerogative to post pictures without express written permission by the patient to do so to conclude a legally valid consent form should have all the modalities of treatment explained to the patient it should also explain to the patient the type of treatment that is best suited to him and what are the alternatives available to him it should explain in great detail the complications or risks however remote that may happen during the procedure it should also mention the cost of the procedure and whether other procedures more procedures will be required to be undertaken in due course of time of what are the medical treatment that the patient has to take to support his hair transplant in the short term and to support his thinning hair in the long term no guarantee should be given unless within the constraints of medical permissibility a full guarantee like in this document here is ethically wrong it is non-professional and does not withstand the test of medical audit but there are so many clinics who give guarantee across the board to patients just to lure them for a hair transplant because they are desperate clinics that in desperate situation to get patient patients who not done their research will not understand that a guarantee like this is not truthful it is not ethical and that and and that it is not best practice for a medical clinic to give guarantees for medical procedures there is no guarantee for human life other than giving the guarantee of good growth giving the guarantee of good coverage whatever is an accepted outcome or an outcome from a hair transplant we see day to day from one patient to the other on a regular basis only that guarantee can be given to the patient and not a full guarantee and like in this document that you have seen but this document is only unethical behavior expediency on the part of the clinic luring the client for a procedure which he might not be interested in this sort of a guarantee reeks of expediency unethical behavior and actually is a form of solicitation which is not permissible in any field in medical which is not permissible in any medical field any clinic which gives a guarantee like this when a poor result happens and in such clinics they are very regular these clinics are famous for not even picking up the phone blocking the clients not giving them access to a regressor and if the patient does reach the clinic the doctor the so-called doctor who did the procedure since most of these at turnkey clinics it is very easy for them to say that the doctor who did your hair transplant is no longer in the employment of the clinic so this is all unethical practice if you promise a patient the moon and you cannot deliver it it harms the medical profession on a whole a reputed clinic will never indulge in such allurements they will not solicit the client for a hair transplant they will not give him huge discounts to coerce him into signing up when he is not yet ready for a reputed clinic has a reputation to maintain a repeated clinic has a host of results a host of successful cases posted on the website posted on various social media and it has a reputation born out of many years of ethical practice so a reputed clinic will not indulge in unethical activities and will always stand by the patient whether you get a good result which is most common in such clinics or remotely if you develop poor growth the clinic will do all that it possibly can within resources to make you happy this may entail a touch-up procedure so in short a consent is a conscience keeper between the client and the clinic or the doctor and is a document to ensure sustained trust and optimal goodwill and bone homie between the two parties thank you for watching my video if you have any questions any queries any clarifications you seek about this talk or about anything else in the field of hair restoration surgery do drop me a comment below thank you for watching [Music]