Within ethics in contemporary medical care, the principle of respect for the patient was originally created, but over time the idea of informed consent has provided a capital value whose evolution has gone hand in hand with the public health revolution. A review of the fundamental elements of the informed consent process reveals disconnects between theory, clinical practice, and patient preferences. Therefore, we pursue as an objective to reflect on the effectiveness of informed consent in Neurosurgery, a specialty that, due to its peculiarities, requires high rigor in both medical and patient decision-making. A critical review of the topic applied to surgery as a surgical specialty is carried out and taken to a deeper approach in the case of neurosurgery as a super specialty. Obtaining and documenting informed consent is of vital interest to the physician. Your omission may constitute a violation, in your non-consensual way of acting, or professional negligence. Clinical conditions, functional abilities, and prognosis can change rapidly, requiring ongoing discussion that can just as quickly change family members' minds. Given that routine informed consent appears to be suboptimal, we suggest that its quality be regularly and rigorously evaluated, as part of the monitoring and assessment of care processes, taking into account the peculiarities of surgical specialties, particularly in Neurosurgery, where it may be affected. patients' state of consciousness