Most patients fear colonoscopy, with the most frequent concerns regarding the potential discomfort and pain associated with the procedure, as well as the sense of uncertainty related to the use of anaesthesia. Common worries include the potential pain, the possibility of regaining consciousness during the procedure, experiencing nausea and vomiting afterwards, but also not waking at all. Patients tend to calm down once they receive adequate information aimed at reducing the stress associated with the procedure. In daily life, people have different ways of using and processing information to handle stressful situations. There are two types of personalities, namely those who gain a sense of control by acquiring information and thus seek more of it, and those who prefer to avoid excess information. First-hand information from the treating physician allows the patient to feel they are taken seriously, and their concerns are understood and respected. Hence, in daily clinical practice providing the patient with adequate information to explain the course of management and the physician’s rationale and intentions is another way of ensuring the patient’s sense of dignity. It is worth remembering, however, that different patients seek various amounts of information from specialists, depending on their ability to comprehend medical facts and their own circumstances. An experienced clinician should be able to tailor information to the patient’s actual needs. There are also special circumstances, where during a diagnostic procedure it becomes necessary to take action beyond what the patient initially consented to. Such circumstances are best avoided by extending the anaesthetic consent form and anaesthetic record with relevant information on analgosedation, anaesthesia and the possible rare serious complications requiring the medical team to undertake additional measures. It should clearly state that under certain circumstances the procedure may be altered, or it may be necessary to extend it with some invasive methods and/or tracheal intubation and mechanical ventilation. The use of analgosedation during colonoscopy increases the patient’s comfort and their acceptance of the procedure, whilst ensuring better examination conditions for the medical team. While intravenous analgosedation raises the overall cost of colonoscopy, it improves its efficiency and the patient’s assessment of the procedure, usually warranting the patient’s consent for a repeat examination if necessary.

The last two decades have seen major a shift in the physician-patient relationship. An important element of the quality change in question has become the protection of every patient’s autonomy and respect for their bodily integrity expressed by their right to make decisions that shape their lives. It is now one of the cornerstones of ethical and legal medical treatment. At present, informed consent for a medical procedure is defined as the patient’s or the patient’s statutory representative’s act of will, voluntarily made and expressed according to definitions shared and understood by other participants of the medical process, based on relevant information that should be reliable and thorough, yet tailored to the patient’s comprehension, and concern all the subsequent stages of the intended course of medical treatment. The first signals of the changes in question, initiated in the US in the 1950s, merely modified the ubiquitous paternalistic approach in medicine whereby all medical decisions were solely based on the treating physician’s belief that a given course of management was in the patient’s best interest (1, 2). The Nurnberg Principles of 1948 and the Helsinki Declaration of Human Rights (1946) played an important role in altering this approach. The documents outlined the principles of conducting scientific research on humans, and became the foundation for the moral and legal rules concerning the whole body of medical practice. The shift that took place was manifested by placing strong emphasis on the patient’s consent to any medical intervention. Thereby, a new concept of the patient’s consent, termed informed consent, evolved from the largely formal act previously in place. The modern approach reinforced two elements of the patient’s decision-making process, namely the patient’s awareness based on received information and the right to freely express consent (1, 2). Obtaining the patient’s informed consent for colonoscopy and analgosedation during the procedure is a crucial element of every patient’s pre-procedure assessment. Informed consent is one of the aspects of the patient-physician relationship, a process whereby the patient and the healthcare practitioner engage in making a joint decision about the prospective treatment. To avoid possible pitfalls while eliciting informed consent for diagnostic and therapeutic procedures, it is important to ensure good reciprocal communication and the patient’s thorough understanding of the relevant medical and legal definitions and guidelines for the adopted course of management, as well as the regulations in force in the country in question. Despite sharing numerous elements with contemporary medical law in other European countries and in the United States, the principles of medical practice in Poland are in some details at odds with other jurisdictions.