Questions to ask the doctor before consenting to surgery

The comments section is closed.

  • John Norfleet says:

    More people and patients need to understand the procedures, diagnosis, recommendations and risks of any potential operation complicated or not. This guide will help you understand some of the basic procedures one could follow.

  • Ryan_123 says:

    Great! It’s really useful for people to know more about the surgery they are going to have. I am going to have my hernia surgery from Shouldice Hospital, Ontario the next Friday and this article is really useful for me too to make some questions to ask my surgeon before my surgery,

  • Judith Wahl says:

    Although I think its good advice to encourage people to do some “advance care planning” Its time that people STOP advising patients to do documents called advance directives or living wills if they live in Ontario because there are no such documents in the Ontario law. Its also time to stop misstating what an advance care plan does and to whom it “speaks” to .

    In Ontario advance care planning involves two elements
    a. a patient either understanding who is their automatic substitute decision maker for health care as defined in the Health Care Consent Act who is the person who would give or refuse consents to treatments for the patient if the patient should become incapable to do so for themselves. OR the patient completing a Power of Attorney for Personal Care to choose someone to act for them if they should become incapable. The Health Care consent Act sets out a hierarchy of SDMs that would automatically be a patients SDM should they become incapable. EVERYONE in Ontario therefore has an automatic SDM . The advance planning helps patients understand who that person is , and gives them a chance to pick someone one else if they don’t want that automatic SDM to act for them.
    b. the patients expressing their WISHES ( not decisions ) about future care as well as their values and beliefs that may impact on how they would make health decisions if they were able to do so. These wishes, values and beliefs are expressed to help guide the patient’s SDM ( not the patients health providers) when the SDM is in the role of making decisions on behalf of the patient when the patient is incapable. . These wishes are relevant to the health providers only in an emergency .

    Advance care planning is NOT decision making about future care . Its SPECULATION about what a patient MIGHT want or not want IF something should happen . Its speculative. In Ontario, the law requires health providers to talk to a PERSON . not to look at any advance care plan form , when getting consent to treatments for the patient . The health provider must talk to the patient and get consent from the patient if capable . If that patient is not capable to give or refuse consent , the health provider must turn to the patients SDM and not any written statement of wishes about future care .

    Its the SDM that looks at any written wishes, values and beliefs and uses these as a guide to help the SDM make the decisions that patients might have wanted if the patient was capable. The SDM interprets the wishes and applies them to the decisions that need to be made after also getting all the information about the patients conditions and the risks, benefits , side affects and alternatives to the treatment options from the health provider . to then make an informed decision in context with all the information.

    So its important that before surgery the patient do some advance care planning . I do agree with that . But the planning they need to do is making sure they understand who is their SDM , and choosing an SDM they want if they don’t want the automatic SDM . They should also TALK to that future SDM to discuss their wishes , values and beliefs so that eth SDM is prepared to make decisions for the patient should the patient be temporarily or long term not capable to speak for themselves.

    Its important to stop using the word “advance directive” to explain this planning . First of all, in Ontario, a patient doesn’t have to WRITE DWN these wishes , values, and beliefs but can express them orally . That’s just as valid as writing them down . The only thin that a person MUST write down in a document is the appointment of an SDM if they don’t want the automatic SDM . That appointment of an SDM of choice must be done by a POAPC which is a written document .

    Also the term “directive” is misunderstood by health professionals as something that they must take direction from when in fact , in Ontario, the advance care plan documents ( or oral statements) are NOT “directives” to the health providers but are communications to the patients future SDMs . In an emergency the health provider should follow any wishes as expressed by the patient when capable but for most decisions , the health providers must turn to the patients SDM if the patient becomes incapable. So then the SDM uses the oral or written wishes to help inform the SDM as to how to make decisions for the patient.

    For more information on the law related to informed consent and advance care planning please see the research paper prepared by the law firms of Dykeman , Dewhurst, O’Brien and the Advocacy Centre for the Elderly on the website of the Law Commission of Ontario at

    ACE is working on a series of plain language explanations of health care consent , advance care planning , the role of SDMs etc that will be available in October on the ACE website at
    Judith Wahl, Barrister and Solicitor, Executive Director, Advocacy Centre for the Elderly

    • Paul Taylor says:

      Thank you for your valuable comments. I know you have a great deal of expert knowledge in this area. So your thoughtful contribution is most welcome.

      My intention was simply to raise the idea that patients should be thinking about what might happen to them if they can no longer speak for themselves.

      A lot more can be said about this issue than what I mentioned here. That’s why I imbedded a link to the website of “Speak Up” for those who wanted additional information.

      I am not sure what you think about Speak Up website. But I certainly agree your main point – it’s best for patients to appoint a substitute decision maker who can speak on their behalf.


Paul Taylor


Paul Taylor is a health journalist and former Patient Navigation Advisor at Sunnybrook Health Sciences Centre, where he provided advice and answered questions from patients and their families. Paul will continue to write occasional columns for Healthy Debate.

Republish this article

Republish this article on your website under the creative commons licence.

Learn more