13/01/2026

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TUESDAY | JAN 13, 2026

COMMENT by Dr Nabil Mohammad Azmi and Redza Zakaria

F OR many Malaysians, medical consent is still seen as a quick administrative step – a signature on a form before an operation. A common misconception among patients is that signing the form absolves doctors of responsibility and shields hospitals from liability. Others think they have no choice once a procedure is proposed. In reality, informed consent is far more than just paperwork; it is a foundation of ethical medical care, a fundamental patient right and a vital safeguard for both the public and healthcare professionals. True consent builds trust No surgical procedure is entirely risk-free. Even routine procedures carry potential complications – bleeding, infection, anaesthetic risks or the need for further intervention. Informed consent ensures patients understand these risks before entering the operating theatre, not after something goes wrong. More than a legal requirement, it is a process that builds trust and cooperation between doctor and patient. Trust is the pillar of a doctor–patient relationship, and meaningful consent is central to that trust. When patients understand their condition as well as the benefits and risks of each treatment option, they approach surgery with confidence rather than fear or doubt. Studies consistently show that well-informed patients experience less anxiety, better adherence to treatment and improved recovery after surgery. Consent is not about protecting hospitals and doctors; it is about respecting patients’ autonomy, dignity and right to make decisions about their own bodies. Why Malaysians sign without understanding Even with higher medical standards, medical jargon can be confusing for many Malaysians to understand. Medical terms like “obstruction”, “adhesion” or “malignant” may sound familiar but are often poorly understood. In busy clinics and hospitals, patients may hesitate to ask questions and doctors may not always have adequate time to explain complex procedures in detail. These practical constraints reflect deeper, systemic issues. Cultural deference towards doctors and healthcare workers can discourage patients from seeking clarification, as questioning authority is sometimes perceived as impolite or disrespectful. Limited health literacy further compounds the problem, increasing the risk that patients consent to procedures they do not fully understand. In Malaysia, strong family-oriented decision

Informed consent is more than just a signature

making can also affect patient autonomy. Relatives may step in to make choices, at times overriding the patient’s preferences or wishes. Patients must be empowered to understand that valid consent rests with them. Only the patient’s informed and voluntary signature authorises a procedure – not the wishes of family members, however well-intentioned. To sign or not to sign In Malaysia, patients have the right to receive sufficient information about their condition. They are also entitled to a clear explanation of any proposed treatment, including the planned procedure and the common possible complications, before it begins. This enables patients to make informed decisions about whether to proceed. Doctors are legally required to inform patients of the risks involved in any proposed treatment. Under Provision 2 of the Malaysian Medical Council (MMC) 2016 guidelines, obtaining valid consent is a core component of good medical practice and carries specific legal responsibilities. Failure to do so may result in disciplinary action for breaching professional ethics and, in some cases, legal claims for assault or battery against the medical practitioner or institution. The MMC guidelines also require that consent be taken by a fully registered medical practitioner, who is responsible for performing the procedure, examination or treatment in question. Consent cannot be delegated casually. Importantly, consent is a process, not a formality. A general consent form is inadequate if patients are not properly informed of the relevant risks. Doctors must take the time to explain procedures clearly and ensure patients genuinely understand what they are agreeing to. Beyond the signature Malaysia’s healthcare landscape is evolving rapidly. With more complex procedures, increasing chronic diseases and cancer diagnosis, and rising awareness of patient rights, medical consent must evolve too. Doctors should use simpler language, allow adequate time for discussions and document

Malaysia’s healthcare landscape is evolving rapidly. With more complex procedures, increasing chronic diseases and cancer diagnosis and rising awareness of patient rights, medical consent must evolve too. – REUTERSPIC

and doctors if complications arise or allegations of negligence occur during or after a procedure. Written consent can be used as official evidence if a dispute proceeds to court. In the case of Pannir Selvam a/l Sinnaiyah and Anor v Tan Chia Foo and Others, the court held that documentary evidence may be admitted to avoid unnecessary delay or expense, subject to the court’s discretion under Section 73A of the Evidence Act 1950. Section 73A allows documents to be admitted in civil proceedings without calling the maker, including situations where the individual is unavailable. This case underscores the importance of proper documentation, particularly written consent, in supporting claims and defending actions in court. Dr Nabil Mohammad Azmi is a surgeon and lecturer at the Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia and Redza Zakaria is the deputy head unit of Maritime Law, Policy and Governance at the Institute of Ocean Earth and Sciences and senior lecturer at the Faculty of Law, Universiti Malaya. Comments: letters@thesundaily.com

conversations enhance understanding, doctors should provide printed materials and visual aids. Equally important are strong communication skills. Doctors must listen actively, respond with empathy and ensure patients feel heard and respected. Meaningful consent is not achieved through forms alone but through clear, compassionate dialogue. Under Section 47(3) of the Private Healthcare Facilities and Services Regulations 2006, a patient’s consent is generally required to be given in writing. Where a standard consent form is not used, healthcare providers must clearly record in the patient’s medical notes that the patient was adequately informed about the procedure and had agreed to it. Having this information in writing is important because it clearly sets out responsibilities and helps protect both doctors and patients if something goes wrong during the procedure, such as complications during the surgery or alleged negligence. Written consent is crucial as it clearly defines responsibilities and helps protect both patients clearly. To

Education retains its importance in the Malaysian landscape for parents, students and stakeholders. The changes are fast paced with new developments in new fields of study such as cybersecurity, data protection, augmented and virtual reality, machine learning in education, digital education and artificial Intelligence. Leading the way are universities, who are invited to showcase their latest programmes, curriculum and content in our Education Focus for 2026.

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