There is nowadays a widespread belief that it is right for patients to be actively involved in decisions about their care (Coulter 1999). Much time is given to informed consent before surgery. The balance of risks and benefits is discussed with the patient before proceeding to an operation. Discussion prior to a surgical intervention is more formalized than for medical intervention, such as drug treatment, because an operation is a unidirectional intervention, once it is done it cannot be undone. What other intervention is unidirectional in the same way as surgery? Giving information shares this property, once you have told a patient something you cannot undo that, you can expand on the information, put it in context, but you cannot retrieve the information.
A large part of what we as neurologists do is to give patients information. We make diagnoses, which we explain to patients, we devise investigation and
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