Signing a consent form does not mean that the doctor is free of liability for every kind of error and harm. Valid informed consent shows an informed decision about a specific intervention. A liability-exclusion clause signed in advance is a different matter: provisions agreeing that there will be no liability even for slight fault in specialized services performed under a statute or with the permission of a competent authority are absolutely void. By contrast, proper disclosure, careful performance and appropriate follow-up can produce results in the physician’s favor in the assessment of compensation. [1] [2]
In operations where the aesthetic purpose predominates and which have the nature of a contract for work (eser sözleşmesi), the separately agreed obligation to achieve the aesthetic result is also examined. Such a dispute cannot be resolved merely by saying “the operation was performed in accordance with medical rules” or “the risk was written on the form.” In decisions of the Court of Cassation (Yargıtay), the undertaking of a result, the clarity of the consent and the management of complications are assessed together. [8] [9] [10] [11] [12]
Before the title of the document in the patient’s hands, one should look at its content, when it was signed and for which procedure it was prepared. The admission, surgery, anesthesia, photo-sharing and payment documents in the same file do not stand in for one another.
How are consent, risk disclosure and a liability-exclusion clause distinguished?
Consent is the legal expression of the patient’s deciding about his or her own body. The risk disclosure forms the informational basis of that decision. A liability-exclusion clause, on the other hand, aims to remove or reduce a liability that may arise in the future. That all three appear in one document does not mean that they will all produce the same legal result.
| Content of the document | What it may show | What it does not show on its own |
|---|---|---|
| Procedure-specific consent | Consent given to the specific procedure | That the procedure was performed with care |
| Explanation of risks and alternatives | Which information was provided | That the patient actually understood and decided freely |
| Hospital admission form | Admission and hospitalization | Sufficient disclosure for every operation |
| Liability-exclusion clause signed in advance | An attempt to limit liability | That the clause is valid |
| Settlement or release after the event | Arrangement of rights in a specific dispute | That all unknown harm was validly settled |
For example, the statement “I consent to a blood transfusion” does not prove that the alternatives to a surgical intervention to be performed separately were explained. Nor is the sentence “I accept all risks” treated as advance permission for the administration of a wrong drug, an unauthorized procedure or a delayed intervention. The court assesses the document together with records of the discussions and other evidence. [2]
Why may liability waivers signed in advance be invalid?
Article 115 of the Turkish Code of Obligations (TBK) and services requiring specialized expertise
Article 115 of the Turkish Code of Obligations declares an advance agreement excluding liability for gross fault absolutely void. The third paragraph of the article also covers advance liability-exclusion agreements concerning slight fault in specialized services that can be performed only under a statute or with the permission of a competent authority. In medical services, this provision prevents the duty of professional care from being removed by the patient’s signature. [1]
For this reason, a clause in a contract reading “no compensation may be claimed for any reason, including a performance error” does not become valid merely because it is written expressly and signed separately. Placing the provision in a separate box or having the patient repeat it by hand does not remove the mandatory prohibition. The special limits in TBK Article 116 regarding auxiliary persons are examined separately.
The consequence of invalidity is not the physician’s automatic liability for every adverse outcome. The patient must still demonstrate the breach on which the specific claim is based, the harm and the causal link. The healthcare institution may also argue, according to the liability regime concerned, that it acted with care and that the disclosure was sufficient. The invalidity of the provision and the satisfaction of the conditions of compensation are different examinations.
Printed contracts and unfair terms
Standard texts prepared in advance may be subject to the review of general terms and conditions under TBK Articles 20–25. If the patient is in the position of a consumer, the review of unfair terms under Article 5 of Law No. 6502 also comes into play. Provisions that are illegible, unclear or foreign to the nature of the contract cannot be left outside the discussion merely on the ground that there is a signature. [1] [3]
However, not every printed consent form is invalid merely because it is printed. It is important that procedure-specific information be added, that the patient’s characteristics be taken into account, that the patient’s questions be answered and that suitable time be given for the decision. A standard explanation and an assessment specific to the patient may coexist.
Why are the result of the work and the clarity of consent examined together in aesthetic operations?
For disputes over aesthetic procedures, see the articles on faulty aesthetic surgery and hair transplantation and faulty Botox and filler applications.
The undertaking of a result does not depend solely on the word “guarantee”
In the Court of Cassation decisions examined below, interventions in which the aesthetic purpose predominates are dealt with under the provisions on the contract for work, TBK Article 470 et seq. In a contract for work, the obligation does not consist solely of carrying out a careful activity; it also includes the performance of bringing about the agreed result. For this reason, the absence of the words “I guarantee” in a separate document does not automatically remove the obligation of result in a relationship having the nature of a contract for work. [8] [9] [10] [11]
What is decisive is which aesthetic purpose the parties agreed upon. The surgical plan, meeting notes, drawings, correspondence, photographs and concrete promises may reveal this purpose. Whether a computer simulation is a binding undertaking or a prediction whose limits have been explained is assessed together with the way it was presented. The patient’s undisclosed personal expectation and the result undertaken by the physician are not the same thing.
In procedures in which therapeutic and aesthetic purposes are present together, the purpose and the performance must be made concrete. For example, in a nose operation, the respiratory function and the appearance goal may be determined separately. It cannot be said that there is a guarantee of cure for every medical procedure; at the same time, treating an aesthetic contract-for-work relationship like a general treatment mandate also overlooks the obligation of result.
The procedure, the expected result and the limits must be clear in the consent
The consent should state in an understandable way the name, region and scope of the operation to be performed and its significant risks. The limits of the appearance the patient wishes to achieve should be explained through concrete matters such as scarring, asymmetry, sensory change or the possibility of reintervention. It cannot be assumed that these are present to the same extent or with the same probability in every operation; the explanation should be specific to the procedure and to the patient.
If more than one aesthetic procedure will be performed in the same session, the scope of the disclosure must be determined for each procedure. The consent obtained for the first operation does not automatically cover a revision procedure of a different nature. A statement such as “any aesthetic procedure deemed necessary may be performed” should also not be used as an open-ended authority to intervene. The clarity of the consent and the clarity of the undertaking of a result complement each other; one does not stand in for the other.
Does a “result is not guaranteed” clause remove liability for the work?
This statement does not resolve the dispute on its own. The contract as a whole, the concrete promises and the aesthetic result undertaken are assessed. Where a particular appearance is promised on the one hand while the printed form removes all liability for the result on the other, the interpretation and validity of the provision must be examined. TBK Article 115, general terms and conditions and the limits in consumer law apply separately. [1] [3]
A valid risk disclosure ensures that the medically possible limits are shared with the patient; it does not remove the examination of whether the agreed work was duly performed. The rights under TBK Article 475 concerning defective performance of the work, as well as separately arising claims for harm, are assessed according to their conditions. Because the human body is involved, free remedy or reintervention cannot be forced on the patient without the patient’s new and free medical consent.
Court of Cassation decisions on aesthetic consent and the undertaking of a result
Facelift: the risk that materialized was not in the consent
Court of Cassation, 6th Civil Chamber, E. 2023/1864, K. 2024/4484, November 28, 2024: After a facelift and submental fat removal, it was found that the agreed appearance had not been achieved and that numbness in the cheeks, although a known complication, was not included in the consent form. The Chamber did not consider it appropriate to rely on a report stating that there was no technical fault; on the ground that, within the characteristics of the file and the amounts claimed, the plaintiff’s claims should be granted, it reversed the dismissal judgment. The decision requires the incomplete disclosure of risk and the result of the work to be examined separately. [8]
The consent for one operation does not cover other aesthetic procedures
Court of Cassation, 6th Civil Chamber, E. 2022/2697, K. 2023/3137, October 4, 2023: Breast reduction/lift and arm lift, together with later revision procedures, were assessed. Although there was a consent for the breast operation, deficiencies in consent were identified for the arm lift and for the later breast augmentation procedure. The Chamber did not find sufficient the expert’s approach, which did not take into account the failure of the undertaken result to materialize and the nature of the contract for work; it reversed the dismissal judgment with respect to non-pecuniary damages and the items of pecuniary harm to be clarified. Defenses relating to patient-related factors did not by themselves cure the deficiency of consent within the scope of the procedure. [9]
Eyelid aesthetic surgery: a technical conformity report alone is not sufficient
Court of Cassation, 6th Civil Chamber, E. 2024/1507, K. 2025/1137, March 19, 2025: Although a complication assessment was made regarding the asymmetry and scars after eyelid surgery, the Chamber took as its basis whether the undertaking of an aesthetic result had been fulfilled. It found it erroneous to rely on a report containing no examination in this respect even though the nature of the contract for work had to be taken into account; it stated that, in the specific file, the liability of the defendants should be accepted and the pecuniary and non-pecuniary claims should be investigated. This decision shows the importance of asking the expert not only about technical fault but also about the agreed result. [10]
The surgical plan may be evidence of the undertaking of a result
Court of Cassation, 15th Civil Chamber, E. 2018/4953, K. 2018/4526, November 19, 2018: The concrete description of the changes to be made in the plan record concerning interventions in the nose and facial region was taken into account with regard to the undertaking of a result. On the assessment that the expected result had not been reached despite repeated operations, the dismissal judgment was reversed. Because of the date of the contract, the framework of the repealed Law No. 818 is also reflected in the decision; the old procedural or time-limit statements of the decision should not be transposed as they are to present-day files. Its contribution to current files is that a surgical plan can reveal the undertaking. [11]
A contract for work does not mean compensation for every dissatisfaction
Court of Cassation, 6th Civil Chamber, E. 2023/3351, K. 2024/4934, December 18, 2024: The dismissal judgment was affirmed on the basis of the expert examinations, which found no marked deformity or need for revision, together with before-and-after photographs and sufficient disclosure. Accordingly, the obligation of result is not applied as the automatic acceptance of all subjective dissatisfaction. The concrete appearance, the undertaking and the evidence must be examined together. [12]
These decisions are specific to their facts. A reversal decision does not mean that the same amount of compensation will be paid to every similar patient or that the outcome of the subsequent proceedings is known.
What information must valid disclosure contain?
Within the framework of Articles 15 and 18 of the Patient Rights Regulation (Hasta Hakları Yönetmeliği), the disclosure must cover the course of the illness, by whom and how the proposed intervention will be performed, the expected benefit, the significant risks, the alternatives and the probable consequences of refusing the intervention. The information must be given in an understandable way. Technical terms alone, or promotional sentences containing a guarantee of result, do not meet this need. [2]
In practice, the following matters are examined together:
- Does the name of the procedure on the form match the procedure actually performed?
- Have the additional risks and alternatives specific to the patient been explained?
- Can it be determined who gave the disclosure and when?
- Was the patient able to ask questions and, where necessary, to obtain the help of an interpreter?
- Was the document signed before the procedure, under sedation or after the procedure was finished?
- Has decision-making capacity and, where necessary, authority of legal representation been assessed?
Procedures for which legislation prescribes a special formal requirement are assessed separately; for major surgical operations, the written-consent rule in Article 70 of Law No. 1219 is important. On the other hand, no generalization can be made as if a single standard written form were mandatory for every medical contact. Where writing is required, satisfying it also does not mean that the content is sufficient. [2] [4]
Emergencies and extension of the intervention
Special exceptions may come into play where the patient cannot express his or her will, where there is a danger to life or where delay would have serious consequences. The reason for the exception, the scope of the intervention and why it could not be awaited should be recorded. The patient’s being unconscious does not create unlimited authority for all additional procedures. A previously known valid refusal, the situation of representation and the necessity of the intervention are assessed together. [2]
What do the signature and the form prove in a dispute?
A signed document is important evidence; but it does not automatically lead to the conclusion that information not explained in the document was necessarily given orally. As to the allegation that the duty of disclosure was fulfilled, the records submitted by the physician and the institution must be assessed. The patient’s allegation must also be made concrete: what is the risk that was not explained, which alternative was not mentioned, under what conditions was the decision made?
If the signature does not belong to the patient, was placed on a blank page, or it is claimed that additions were made to the text afterward, the original of the document, its dates, the change history of electronic records and, where necessary, a document examination become important. It is useful not to be content with keeping the document only as a photograph, but to request the signed copy and all its attachments. The right to examine patient records and to obtain a copy is regulated in Article 16 of the Patient Rights Regulation. [2]
The explanation “I signed without reading” does not in every case create invalidity on its own. By contrast, failure to give the patient the opportunity to read, the provision of wrong information, a language barrier or pressure affecting the will may change the assessment. The discussion of proof should not be reduced to the signature alone.
For the proof of malpractice, see our article on how malpractice is proven.
Does writing down a complication protect the doctor?
The occurrence of a known complication does not, by itself, mean medical error. However, the fact that a risk is of a known nature does not remove the duties of appropriate patient selection, performance in accordance with technique, early diagnosis and necessary intervention. A problem that could not be avoided at the outset may have been aggravated by a lack of follow-up or intervention.
In the decision of the 3rd Civil Chamber of the Court of Cassation dated December 2, 2024, E. 2024/436, K. 2024/3992, the dismissal judgment was affirmed taking into account together that the result after a hip prosthesis revision was assessed as a complication in the expert reports, that the treatment and follow-up were found appropriate and that consent was obtained. The basis of the decision is not the signature alone. This decision shows that properly obtained consent, together with the other evidence of careful treatment, may carry weight in the physician’s favor. [5]
In the decision of the 10th Chamber of the Council of State (Danıştay) dated November 6, 2023, E. 2019/8345, K. 2023/6457, on the other hand, importance was attached to the fact that a general form relating to the repair of prominent ears did not explain the risks and consequences specific to the procedure. While the dismissal of the claim for pecuniary damages was affirmed, the decision was reversed with respect to non-pecuniary damages based on the deficiency of disclosure. This distinction shows that a fault in performance and a violation of the patient’s right to decide must be assessed separately. It cannot be concluded that all bodily harm will automatically be paid for every deficiency in consent. [6]
Is a release signed after the procedure subject to the same rule?
A settlement or release made after the harm has arisen to resolve a specific dispute is not the same as a liability-exclusion document obtained in advance for future fault. Within the framework of TBK Article 132 and the provisions on defects of intent, what the parties knew, which claims were covered and what consideration was given are examined. [1]
A document stating “I received the refund of the fee” may confirm only the refund of the fee. If a clause such as “I waive all my present and future rights” has been added to it, the scope is discussed separately. Vague wording about the cost of a repeat operation, permanent loss of working capacity or harm not yet medically determined may create a serious dispute. Provisions that end all rights without payment being received and the settlement of only specific items in return for partial payment do not produce the same consequences.
For settlement and release agreements, see our article on mediation and settlement in malpractice disputes.
Which documents and routes matter when seeking redress?
The hospital file, all copies of the consent, the contract, invoices, appointment records, correspondence and the pre-procedure disclosure documents should be gathered together. The complaint and the development of the harm should be placed in chronological order. It should not be forgotten that, while the medical assessment is continuing, time limits may continue to run.
In a dispute concerning private healthcare services, the consumer transaction, contract and tort bases are examined separately; in service fault in a public hospital, application to the administration and the full remedy action route are examined separately. There is no single “malpractice period” for the statute of limitations. Whether the claim is characterized as tort, mandate, contract for work or another contract changes the result. A criminal complaint or an application to the patient rights unit does not by itself preserve the compensation period. [1] [3] [7]
For disclosure in PRP and similar procedures, see our article on patient rights in PRP, mesotherapy and ozone applications, and for the service page, see medical malpractice and physician error cases.
Conclusion
A consent form serves to document the patient’s informed decision. It is not a guarantee that removes the duty of professional care. A sound assessment addresses separately the type of the document, the content of the disclosure, the medical appropriateness of the performance and the scope of agreements made afterward. As much as the patient’s signature, what the patient signed for and under what conditions is important.
Frequently Asked Questions
I signed a statement reading “I accept all risks”; can I file a lawsuit?
This sentence alone does not remove the right to sue. The validity of the advance liability-exclusion clause, the sufficiency of the disclosure and the other conditions of compensation are examined.
If the risk on the form materialized, can compensation not be obtained?
That the risk was explained is important; but appropriate performance and follow-up are assessed separately. If there is an error in the management of the complication, a different liability may arise.
Do I have the right to request a copy of the form?
The patient may examine the records concerning himself or herself and obtain a copy. The signed consent form and its attachments should be expressly specified in the written request.
Does my relative’s signature stand in for my signature?
For an adult with decision-making capacity, kinship alone does not confer authority of representation. Legal representation, authorization and emergency conditions are examined separately.
If there is no technical error in an aesthetic operation, is there also no liability for the work?
No. In a relationship having the nature of a contract for work, whether the agreed aesthetic result has been achieved is also examined. A report containing only a technical conformity assessment may fall short in the specific file.
Does the consent I gave for one aesthetic procedure also cover other procedures?
It does not cover them automatically. The scope of disclosure and consent for each procedure and for later, different interventions must be determined concretely.
Does accepting a refund of the fee end all rights?
The outcome depends on the scope of the document. A receipt, a partial payment, a release and a settlement are not the same; it must be determined which claims are ended in return for the payment.
Sources and legal bases
- Law No. 6098, Turkish Code of Obligations, especially Arts. 20–25, 49, 72, 112, 115–116, 132, 146–147, 470–475. Official legislation text.
- Patient Rights Regulation, especially Arts. 15–18, 24, 26, 28, 31. Ministry of Health text.
- Law No. 6502 on Consumer Protection, Arts. 5, 73, 73/A. Official legislation text.
- Law No. 1219 on the Practice of Medicine and Its Branches, Art. 70. Official legislation text.
- Court of Cassation, 3rd Civil Chamber, E. 2024/436, K. 2024/3992, December 2, 2024. Decision text — De Jure, may require login.
- Council of State, 10th Chamber, E. 2019/8345, K. 2023/6457, November 6, 2023. Decision text — De Jure, may require login.
- Administrative Procedure Law No. 2577, Arts. 7, 13. Ministry of Justice legislation record.
- Court of Cassation, 6th Civil Chamber, E. 2023/1864, K. 2024/4484, November 28, 2024. Full text — De Jure.
- Court of Cassation, 6th Civil Chamber, E. 2022/2697, K. 2023/3137, October 4, 2023. Full text — De Jure.
- Court of Cassation, 6th Civil Chamber, E. 2024/1507, K. 2025/1137, March 19, 2025. Full text — De Jure.
- Court of Cassation, 15th Civil Chamber, E. 2018/4953, K. 2018/4526, November 19, 2018. Full text — De Jure.
- Court of Cassation, 6th Civil Chamber, E. 2023/3351, K. 2024/4934, December 18, 2024. Full text — De Jure. The links may require login.