The evolution of surgical consent standards in Australia, as guided by the Royal Australian College of Surgeons (RACS), reflects a historical shift from a paternalistic approach to contemporary principles emphasizing patient autonomy and comprehensive information disclosure. The journey has seen a transition from a lack of formalized consent in early surgical practices to the current emphasis on shared decision-making. While RACS advocates for transparent communication and documentation, contemporary challenges arise from the time pressures inherent in modern surgical practice. The historical trajectory underscores a commitment to ensuring patients are well-informed about procedures, risks, and alternatives. However, the exigencies of today's fast-paced surgical environment pose a potential threat to the thoroughness of the consent process. This presentation discusses the tension between historical ethical imperatives and the practical constraints faced by surgeons today. It prompts a critical examination of how time pressures may undermine the capacity to obtain truly informed and voluntary consent, inviting surgeons to navigate this delicate balance in their commitment to patient welfare and ethical practice.