Why routine surgery still needs careful consent
Volume does not lower the standard. A cataract patient consents to a procedure with a real, if small, risk profile, and increasingly to a refractive outcome they have expectations about. Montgomery asks what this patient would want to know. For many, that includes the chance of needing glasses afterwards and the difference between lens options, not only the surgical risks.
The material risks to disclose and document
- Posterior capsule rupture and vitreous loss.
- Endophthalmitis, a rare but sight-threatening infection.
- Retinal detachment and cystoid macular oedema.
- Posterior capsule opacification (needing later laser).
- Refractive surprise and the likely need for glasses for some tasks.
- Rare vision loss.
Lens choice is a McCulloch alternative
The choice between monofocal, toric and multifocal lenses is a choice between reasonable alternatives, each with its own benefits, trade-offs and risks such as glare or halos. McCulloch makes discussing those reasonable alternatives a legal expectation, and Montgomery makes the material risks of the chosen option something the patient must be told. Record the options presented, the trade-offs explained, and the patient's informed choice.
Documenting expectations
Cataract complaints often turn less on the surgery than on the refractive result the patient expected. A defensible record captures what the patient was told about spectacle independence, the realistic outcome for their eyes, and their agreement to the lens plan. Montgomery is satisfied by evidence of that dialogue, not by a signature on a standard form.
Where this sits
Every material risk below is a Montgomery disclosure and, where an alternative exists, a McCulloch one too. If it was discussed, it needs to be on the record. See how the standard rose in the interactive timeline, and how a claim actually unfolds in Anatomy of a Claim.
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