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Being called to sign something during surgery | CION Cancer Clinics
The family is called to sign during surgery when the surgeon finds something that needs a decision the patient did not already agree to, and the patient is asleep. It may mean removing more, adding a stoma or stopping early. You can ask what was found, what each option means, and whether the choice can wait until the patient wakes. This page explains what to ask and what to expect. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Why is the family called to sign something during surgery?
- What might you be asked to agree to?
- What should you do when the call comes?
- What do families often believe about signing during surgery?
- Which questions help you decide quickly?
- Who can sign, and what if the family disagrees?
- What helps you be ready if you are called?
- Common questions about consent during an operation
The short answer
Why is the family called to sign something during surgery?
The family is called when the surgeon finds something during the operation that needs a decision the patient did not already agree to, and the patient is asleep and cannot answer. You are being asked because you know the patient and their wishes, and the surgeon wants that view before going further.
It is not always bad news
Being called in is frightening, and many families assume the worst. The reason can be a bigger operation, but it can also be a choice between two reasonable options, a request to send tissue for extra tests, or an explanation of why the operation is taking longer. Listen to the whole explanation before you decide what it means.
Why most changes do not need a call
Before surgery, the surgeon usually explains the likely possibilities and writes them into the consent form the patient signs. A change covered by that consent goes ahead without calling you. The call is for something that was not discussed, or where the surgeon wants the family's view.
When the surgeon does not wait
If stopping to ask would put the patient's life or health in serious danger, such as heavy bleeding, the surgeon will act first and explain afterwards. That is part of the duty to keep the patient safe.
Before the day, agree as a family who will stay near the theatre and whose phone number the team should use.The situations
What might you be asked to agree to?
Each of these is a real decision. The surgeon should explain what happens with each option, including doing nothing more.
Removing more than planned
The tumour is attached to a nearby organ, and taking part of that organ would give a better chance of removing it fully.
A stoma or a different join
Joining the bowel back together is not safe today, so the surgeon wants to bring it out onto the tummy into a bag, often for a time.
Stopping without removing it
The cancer has spread further than the scans showed, and the surgeon thinks removing it would not help. You may be asked to agree to closing after taking samples.
Blood or extra procedures
Blood, a feeding tube or a tracheostomy, a breathing tube placed in the neck, may be needed that was not listed on the form.
Tell the team at once if
- The patient refuses blood for any reason
- The patient made a written wish about treatment
Not sure whether this applies to you?
Ask an oncologistIn the moment
What should you do when the call comes?
Take one other person with you
Two people remember more than one. If possible, bring the family member who knows the patient's wishes best.
Ask what was found
Ask the surgeon to explain in simple words what they have seen and why it changes things. It is fine to ask them to say it again.
Ask about each option
Ask what happens if you agree, what happens if you do not, and whether the decision could wait until the patient wakes up.
Read before you sign
Check that the form describes what you were told. Ask for a moment to read it, and ask for a copy or a photograph of it for your records.
Commonly believed
What do families often believe about signing during surgery?
"We have no choice. They will do it anyway."
If there is no emergency, you are being asked because your view matters. You can ask questions, ask for options, and ask whether the decision can wait until the patient can decide.
"Signing means we are responsible if something goes wrong."
Signing records that the decision was explained and that you agreed to it on the patient's behalf. The team remains responsible for doing the operation with proper care.
"Being called in means the patient is dying."
Most calls are about a change in the operation, not about an immediate danger to life. In a true emergency the surgeon usually acts first and explains afterwards.
"The eldest son must be the one who signs."
What matters is the patient's wishes and who knows them. The team will usually ask who the patient named as their contact, whoever that is in the family.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Keep this list handy
Which questions help you decide quickly?
Ask this
Why it helps
What have you found, in simple words?
So the whole family understands the same thing
What happens if we agree, and if we do not?
So you are choosing between real options
Can this wait until the patient wakes up?
So the patient decides, if it is safe to wait
How will this change the recovery?
So you can plan for a longer stay or a stoma
Would you recommend this for your own family?
Often the clearest way to hear the surgeon's view
Being straight with you
Who can sign, and what if the family disagrees?
The team will usually speak to the person the patient named as their contact, or the closest family member who is present. You are asked to speak for what the patient would want, not for what you would want for yourself.
When the family does not agree
Families often disagree under pressure. Ask the surgeon for a few minutes to talk it through. If the decision is not urgent, the surgeon may choose the smaller, safer option now and leave the larger decision until the patient can make it. That is often the fairest way through.
If the patient already said what they want
Tell the surgeon if the patient told you, or wrote down, that they would not want a stoma, blood or a certain operation. Their wishes carry the most weight, even when the family feels differently.
What this page cannot tell you
It cannot give legal advice, and it cannot tell you what to decide. Rules and hospital policies vary. If you have concerns about how consent was taken, ask to speak to the hospital's patient relations or medical superintendent's office after the operation.
While you wait
What helps you be ready if you are called?
- Stay close to the theatre waiting area, with your phone charged
- Keep a copy of the consent form the patient signed
- Know the patient's wishes about blood, a stoma and life support
- Have a notebook to write down what the surgeon says
- Agree which one or two family members will speak to the team
- Carry your own photo ID, which the form may ask for
Questions we are asked
Common questions about consent during an operation
Can we refuse to sign during surgery?
Yes. You can say no, or ask for the decision to wait until the patient wakes. The surgeon should then explain what they will do instead. If refusing would put the patient's life in immediate danger, the surgeon may still act to keep them safe, and will explain this to you plainly.
How long do we get to decide?
The patient is under anaesthesia, so time matters, but you should still get enough to understand. Ask the surgeon how much time you realistically have. A few minutes to talk as a family is usually possible, and it is reasonable to ask for it.
What if no family member is at the hospital?
The team may try to reach you by phone, and some decisions can be explained that way and recorded by the staff. If nobody can be reached, the surgeon will usually do what is needed for safety and leave bigger choices for later. This is why it helps to stay close.
Will the patient be told what we agreed?
Yes. Once the patient is awake and able to take it in, the surgeon should explain what was found, what was done and why the family was asked. It helps if the family member who signed is there for that conversation too.
Can we ask for a second opinion in the middle of surgery?
An outside opinion is rarely possible while the patient is asleep. You can ask whether another senior surgeon in the hospital has been involved, and you can ask whether the larger decision can wait so that a second opinion is possible afterwards.
Does the change affect the cost?
It can, through a longer operation, a longer stay or more supplies. Coverage depends on your package and on Aarogyasri, CGHS, ECHS, EHS or cashless insurance. You do not need an exact figure before agreeing to something urgent, but ask the billing desk afterwards.
We are not good with medical words. What do we do?
Say so. Ask the surgeon to explain in Telugu, Hindi or simple English, or to draw a picture. Ask a nurse or a family member who understands better to join you. Nobody should sign something they have not understood.
Can the patient change what we agreed later?
What was done in the operation cannot be undone, but many later decisions can still change. A stoma may be reversed later in some cases, and treatment after surgery is always discussed with the patient. Ask the surgeon what remains open.
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Dr. C. Raghavendra Reddy
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- NHS — Consent to treatment
- National Cancer Institute — Surgery to Treat Cancer
- American Cancer Society — Making treatment decisions
- Macmillan Cancer Support — Surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Why the Plan Can Change Mid-OperationThe reasons behind a call from theatreWaiting During Surgery: A Guide for FamiliesHow to wait so you can be reachedDeciding on Cancer SurgeryThe consent the patient signs before the dayCaretaker and Family Guide to SurgerySupport for the family member making decisions
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