Duty to inform
Your rights as a patient – find out what information you are entitled to before an interventional pain treatment.
The physician’s duty to inform: a cornerstone of patient autonomy
Medical information is not mere formalism, but the legal and ethical prerequisite for any medical treatment. Without valid consent (informed consent), even a professionally performed procedure legally constitutes bodily harm. The aim of providing information is therefore to enable the patient to make an autonomous decision about their body.
Purpose of providing information
- Safeguarding patient autonomy: The patient decides for themselves what happens to their body.
- Basis of trust: It strengthens the relationship of trust between doctor and patient.
- Legal certainty
The doctor–patient relationship is built on trust. The patient must have enough trust to be able to ask any questions. The answers given by the doctor must be fully satisfactory.
The general process of providing information before a procedure
Legally valid information must meet certain formal and content-related criteria:
- The personal consultation:
As a rule, the information must be provided in a personal consultation by the treating physician (or a qualified representative). Simply handing over leaflets or videos is not sufficient; these only serve as support. - Timeliness:
The patient must be informed in good time – meaning they must have sufficient time to consider the pros and cons. For elective (planned) interventions, this should be at least one day before the procedure. Ideally even earlier. - Comprehensibility:
The information must be provided in language that laypeople can understand (avoiding incomprehensible medical jargon). If there are language barriers, an interpreter may need to be involved. - Documentation
The four core elements of patient information
Every information consultation must cover the following four areas:
1. Diagnosis and rationale (indication-related disclosure)
The patient must be informed in an understandable way what condition or finding is present and why the proposed measure (whether surgery, therapy or medication) is medically appropriate and necessary. The consequences of not treating must also be explained.
2. Procedure and risks (course and risk information)
Procedure: What exactly happens during the procedure or therapy? What can the patient expect?
Risks: The patient must be informed about typical and specific risks, as well as rare but serious risks (e.g. paralysis, infections, death) that could be relevant to the decision.
3. Alternatives (information about alternatives)
Are there other medically reasonable methods that achieve a similar goal but involve different risks or burdens? The doctor must not simply promote their preferred method, but must present genuine alternatives (e.g. conservative vs. surgical therapy) fairly.
4. Important behavioural points (safeguarding information)
This includes behavioural instructions for the patient to avoid jeopardising the healing outcome (e.g. fasting before the procedure, taking medication, not driving, rest periods).
Special aspects of interventional pain medicine procedures
Pain medicine (e.g. infiltrations, nerve blocks, epidural injections or implantation of pain pumps / spinal cord stimulators) plays a special role in the duty to inform. As these are often elective procedures (requested procedures to improve quality of life, no acute danger to life), the requirements for the depth of information are particularly high.
Specific risks in focus
In interventional pain therapies (e.g. injections near the spine), the proximity to the nervous system means that very specific risks must be explained
:
- Nerve damage:
therapy-related abnormal sensations, signs of paralysis. - Infections:
e.g. epidural abscess or meningitis with procedures close to the spinal cord. - Bleeding:
haematomas in the spinal canal that can press on nerves. - Unintentional dural puncture:
leads to severe post-dural puncture headache.
“Lack of success” as a point to be explained
An important point in pain medicine: the doctor must explicitly inform the patient that an interventional pain medicine procedure does not guarantee success. There is a risk that the pain will persist despite technically perfect performance, or in rare cases (e.g. due to chronification or nerve irritation) may even worsen.
Alternatives in a multidisciplinary context
Especially in pain medicine, informing about alternatives is essential. Before invasive procedures or surgery are carried out, non-invasive alternatives must be discussed:
- Multimodal pain therapy: Combination of physiotherapy, psychotherapy and medication.
- Conservative medication adjustments
- Complementary medicine approaches
Patient information & consent form
Your rights at a glance
Diagnosis and findings
Your doctor must explain in an understandable way what diagnosis has been made and what findings have been established.
Treatment Options
You have the right to be informed about all available treatment options – including alternatives.
Risks and side effects
Before any procedure, you must be informed about possible risks, complications and side effects.
Procedure process
The exact process of the planned treatment must be explained to you step by step and in an understandable way.
Chances of success
Realistic expectations: your doctor will inform you about the likelihood of success and possible limitations.
Right to time to consider
You may take time before giving your consent. Exceptions apply only in emergencies.
Legal basis
Art. 10a of the Federal Act on Research involving Human Beings (HRA) as well as Art. 28 of the Swiss Civil Code (ZGB) govern the doctor’s duty to inform the patient.
Checklist for your consultation with your doctor
What exactly will be done during the procedure?
What alternatives are there?
What risks and side effects are possible?
How long does recovery take?
What happens if I decide not to have the procedure?
How many such procedures have you already performed?
Is the doctor SSIPM-certified?
