{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T09:14:13Z","timestamp":1775207653520,"version":"3.50.1"},"reference-count":21,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Informed consent is a fundamental ethical and legal requirement in neurosurgical practice, particularly given the high risk of postoperative morbidity and medico-legal litigation. Written documentation of material risk disclosure provides objective evidence that valid consent has been obtained. However, real-world data on neurosurgical consent documentation practices remain limited in Malaysia.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A retrospective observational study was conducted at a tertiary referral center, reviewing elective neurosurgical procedures performed in 2022. Electronic medical records and scanned consent forms were analyzed to determine whether material surgical risks were documented during the consent process. Risk documentation was defined as written evidence of disclosed risks recorded on the consent form or in the medical record. Post-operative complications and clinician involvement in consent taking were recorded for descriptive and contextual purposes.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n A total of 283 elective neurosurgical procedures were included. Documented material risks were identified in 260 cases (91.9%). In 23 (8.1%) cases, no written documentation of risk disclosure was found. Postoperative complications occurred in 54 (19.1%) cases. Complications were more frequent in cases without documented risks (30.4%) compared to those with documentation (18.1%), although this difference was not statistically significant. Registrars most frequently documented clinicians involved in explaining risks.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The most elective neurosurgical procedures in this study were supported by written documentation of material risk disclosure. However, a small but clinically relevant proportion lacked such documentation, representing a potential medico-legal vulnerability. Improving consistency and institutional oversight of consent documentation, particularly in registrar-led consent, may further enhance the consistency, quality, and defensibility of neurosurgical practice.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_148_2026","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T08:17:20Z","timestamp":1775204240000},"page":"205","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Written risk disclosure in elective neurosurgical consent: A retrospective observational study with descriptive postoperative outcomes"],"prefix":"10.25259","volume":"17","author":[{"given":"Muhammad Anas","family":"Kamarudin","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Malaya Medical Center, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalai Arasu","family":"Muthusamy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Malaya Medical Center, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronie Romelean","family":"Jayapalan","sequence":"additional","affiliation":[{"name":"Department of Surgery Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime Jacqueline","family":"Jayapalan","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"10.25259\/SNI_148_2026\/ref-1","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1111\/j.1471-0528.2004.00240.x","article-title":"Informed consent for elective and emergency surgery: Questionnaire study","volume":"111","author":"Akkad","year":"2004","journal-title":"BJOG"},{"key":"10.25259\/SNI_148_2026\/ref-2","first-page":"u210626.w4335","article-title":"Improving consent form documentation and introduction of procedure-specific labels in a district general hospital","volume":"5","author":"Bajada","year":"2016","journal-title":"BMJ Qual Improv Rep"},{"key":"10.25259\/SNI_148_2026\/ref-3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1080\/15265161.2019.1665402","article-title":"Principles of biomedical ethics: Marking its fortieth anniversary","volume":"19","author":"Beauchamp","year":"2019","journal-title":"Am J Bioeth"},{"key":"10.25259\/SNI_148_2026\/ref-4","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1016\/j.pec.2021.10.009","article-title":"Learning from informed consent litigation to improve practices: A systematic review","volume":"105","author":"Giudici-Wach","year":"2022","journal-title":"Patient Educ 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\u2018Montgomery\u2019 is result of evolutionary change of medical practice towards \u2018patient-centred care\u2019","volume":"93","author":"Lee","year":"2017","journal-title":"Postgrad Med J"},{"key":"10.25259\/SNI_148_2026\/ref-12","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.zefq.2022.04.020","article-title":"Shared decision-making in Malaysia: Legislation, patient involvement, implementation and the impact of COVID-19","volume":"171","author":"Lee","year":"2022","journal-title":"Z Evid Fortbild Qual Gesundheitswes"},{"key":"10.25259\/SNI_148_2026\/ref-13","article-title":"Annual Report","author":"Malaysian Medical Council","year":"2013"},{"key":"10.25259\/SNI_148_2026\/ref-14","article-title":"Good Medical Practice","author":"Malaysian Medical Council","year":"2019"},{"key":"10.25259\/SNI_148_2026\/ref-16","article-title":"Consent for Treatment of Patients by Registered Medical Practitioners","author":"Malaysian Medical 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