As I was boarding a plane to fly to the east coast to handle a relative’s medical emergency, an orthopedic surgeon phoned from the emergency room.  He described my elderly relative’s injuries in detail, explained the operation he proposed, and answered my questions. He rattled off a list of possible complications and asked for my permission to operate.  I gave it to him.

Then he put a nurse on the phone.  I played back for her my understanding of the planned operation and its risks, and again gave my consent.

“Oh, this makes sense!” I thought.  “Because they can’t get my signature, they require that I two different people each document that I said yes.”  

I arrived at the hospital straight from the airport, 14 hours after I had gotten the call saying that my relative was injured.  There, I went directly to the surgical suite and joined my relative and the second person named in her health care directive.  I had called him before I left for the Phoenix airport.  He had been on the east coast already, and got to my relative’s bedside about five hours before I did. 

“It’s a good thing I was here,” he greeted me.  “They said if no one had been here to sign the consent paperwork, they would have had to delay the surgery to tomorrow.”

I felt as if the carpet had been pulled out from under my feet.  I had already given consent!  But I couldn’t focus on this disconnect at that moment; twenty minutes after I arrived, my relative was taken into the operating room.

After all the activity died down a few days later, I called the Patient Relations department.  When I described the above events, the representative was as baffled as I was. 

“There aren’t any more consents required!” she said.  “I don’t know why anyone would have said that they needed a signature, when you had already given consent by phone!”

She promised to get back to me with answers.  But it’s been several weeks, and I haven’t heard a word.  Whatever the story turns out to be, if you find yourself giving consent long distance, you might ask:

• Is anything else needed from me before surgery can proceed?
• Are any other consents or information needed?
• Who else needs to know that consent has been given?
• How will they find out that I have consented?

By asking these questions, you may reduce the odds that gaps in communication in the hospital will cause unnecessary delays in treating your loved one.  You will also know that you have taken all the steps you can reasonably take.  Then the ball is in the doctor’s or hospital’s court.