Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Never ever perform any surgical procedure without patient's or carer's consent. Always spend some time discussing with the patient or carer about the possible complications of a particular procedure and discuss that there may arise a situation during the surgery to do extra procedures, including removal of adjacent structures, in the long term interest of the patient. All of this must be documented as it is far better to spend some time with the patient or carer before getting consent than having to suffer the torture of facing GMC or even the Police. That can surely be the worst nightmare of any surgeon's career.