Informed consent is not a form – it is a conversation. Dr Cornelia Els, consultant to the Veterinary Defence Association, unpacks what ‘informed’ actually means, why generic consent forms fall short, and how documenting the discussion, not just the signature, protects both the client’s right to decide and the veterinarian’s legal position. 

Did the client really understand what they agreed to? It is a question that comes up in almost every complaint file that crosses my desk — and it is rarely about whether consent was obtained. It’s about whether it was informed. Informed consent is not a form. It is not a signature. It is a conversation, and if that conversation did not happen properly, the signature at the bottom of the page wouldn’t save you. 

It is 7h30, and the waiting room is full. Bella, a nine-year-old Yorkie, is dropped off for her third dental in three years by her owner’s wife — she practically knows the drill by now. The receptionist checks her in, pulls up last year’s consent form, updates the date, and has her sign before rushing off to work. The vet, mid-consult with another patient, glances at the form on the way to theatre. It looks the same as always, so she does not stop to check it. 

By the time Bella’s dental is done that afternoon, she has developed a jaw fracture during extraction — rare, but not impossible in a small-breed dog with advanced periodontal disease. Her owner’s husband, collecting her that evening, is furious: Nobody told him this could happen. The vet is confident it was mentioned ‘last time’. But the consent form says nothing about fracture risk, does not reflect any breed- or age-specific discussion, and was filled in by a receptionist who has never been in theatre. 

A few weeks later, Max, a young Boerboel, is booked in for a lump removal. His owner’s wife calls ahead. The receptionist, mid-call with another client waiting, ducks into theatre and asks the vet for a rough number, then writes it on the form as the quote. On the table, the vet finds a second, larger mass nearby and removes that one too, reasoning any owner would obviously want it dealt with in the same trip. Max’s owner, collecting him that afternoon, is billed for two removals he only consented to one of — and hears about the second mass for the first time at the till. 

He is not wrong to feel like the decision was made without him. A rough number given in passing, and a treatment decision made mid-procedure on the vet’s own judgment, both skip the one thing that actually matters — telling the client and letting them decide. 

Variations on this theme show up constantly. Rosie’s owner could not be reached when the vet found a mass far worse than the scans suggested and had to decide alone whether to proceed. Tumble’s family expected a full recovery and got a permanent head tilt instead — a ‘successful’ surgery that did not look like what they had pictured. Duke’s owner had her phone off in a meeting. The practice tried her three times over twenty minutes before the vet made the call alone, in theatre, and Duke never woke up. 

It is the same pattern in almost every consent complaint that crosses my desk: Decisions made for the client instead of with them, and a gap between what was actually discussed and what is on paper. 

What ‘informed’ actually means 

Consent is only valid if the client had enough information to make a real choice. In practice, that means a reasonable client — not a veterinarian, not a specialist, an ordinary pet or livestock owner — needs to understand: 

• What you are proposing to do, in plain terms. 

• Why — the diagnosis or suspected diagnosis prompting the procedure. 

• The material risks involved, including the ones that are rare but serious. 

• The reasonable alternatives, including doing nothing. 

• The likely cost, and what happens if complications push that cost up. 

• The prognosis — with and without treatment 

If a client cannot repeat this back to you in their own words, they probably were not informed. That is the standard a court or the South African Veterinary Council (SAVC) will apply after the fact, however good your intentions were at the time. 

The word that trips vets up: ‘Material’ 

You do not need to disclose every conceivable risk — that is neither possible nor useful, and it can overwhelm a client into decision paralysis. What you need to disclose is what is material: Risks that are either common, or rare but severe, or specifically relevant to this particular animal, this particular procedure, this particular client. 

A rare but severe complication still needs mentioning, even if it is unlikely. A client with a nervous breed, a geriatric patient, or a known drug sensitivity changes what is material for that consultation. Materiality is assessed from the client’s perspective, not yours — would this client, with this animal, have wanted to know? The consent form is evidence that a conversation happened. It is not a substitute for the conversation. 

Where consent forms go wrong 

I regularly see disciplinary and civil matters where the paperwork looks fine on its face but falls apart under scrutiny. Common failure points: 

• Generic forms treated as sufficient. A blanket ‘I consent to treatment’ line does not discharge the duty if the specific risks of this procedure were never actually discussed. 

• No record of the discussion itself. If the consult notes do not reflect what was disclosed, you are relying on memory — yours, months or years later, against a client who says they were never told. 

• Consent taken from the wrong person. Verify you are dealing with the animal’s owner or someone with authority to consent on their behalf, particularly in boarding, referral, or multi-owner situations. 

• Estimates or consent detail filled in by reception, not the vet. If non-clinical staff assist with the paperwork or a quote, the treating vet still needs to confirm what was actually disclosed, before signature. 

• Handwriting and figures not corroborated. Cost estimates and options discussed on the form should match what is in your clinical notes. Discrepancies between the two are one of the first things scrutinised in a complaint. 

• Consent obtained too late. Consent given as the animal is already being wheeled into theatre, under time pressure, is vulnerable to challenge — particularly for elective or non-urgent procedures. 

• If reception is taking bookings, quotes, or intake details, the estimate needs a standing caveat, said out loud and put in writing, that costs may change if the clinical picture does — and the treating vet should be the one confirming that has been said, before the procedure, not explaining it after the invoice. 

Practical steps that hold up 

Document the discussion in your clinical notes, not just the signed form — what was explained, what alternatives were offered, and how the client responded.  

• Use the consent form to support the conversation, not replace it. For higher-risk or costly procedures, build in a brief pause before signature so the client is not rushed. 

• Where a client declines a recommended option, record that too — informed consent includes the right to informed refusal. 

• Revisit consent if the clinical picture changes intraoperatively in ways the client did not anticipate. 

• Treat consent as occasion-specific, not indefinite — a returning patient like Bella does not come with standing consent attached. 

The bottom line 

Informed consent protects the client’s right to decide what happens to their animal — and it protects you, but only if it is genuine. A signed form backed by a real, documented conversation is a strong defence. A signed form standing alone is not. If you are ever unsure whether you have disclosed enough, ask yourself what a reasonable client, in this specific situation, would have wanted to know before saying yes. If in doubt, tell them. As for Bella and Max — a two-minute conversation, at the right moment, would have closed both gaps. That is the whole exercise, really: not more paperwork, just making sure the paperwork reflects a conversation that actually happened, with the person who is actually deciding. 

Dr Cornelia Els is a dual-qualified veterinarian and attorney, and a consultant to the Veterinary Defence Association, where she advises on SAVC disciplinary matters, professional liability, and legal risk in veterinary practice.