The standard of informed consent in Nigerian medical practice has shifted. Where 'the patient signed the form' once sufficed, both the MDCN and the courts now expect a substantive consent process, documented, contemporaneous, and patient-specific.
The new standard, in practice. A patient must be informed of (a) the nature of the procedure, (b) material risks (including those a reasonable patient in their position would consider material), (c) reasonable alternatives, and (d) the consequences of declining treatment.
What clinics should change. Move from a single signed page to a structured record: a discussion note in the patient's file, a counter-signed risk summary, and for elective or higher-risk procedures, a 24-hour cooling-off period where clinically appropriate.
Capacity and surrogate consent. For patients lacking capacity, the consent framework follows a hierarchy: advance directive (rare in Nigeria), spouse, adult child, parent, sibling. Document the basis on which the surrogate was selected.
Done well, this protects patients first and the clinician second. Done as paperwork, it protects neither.