The sentence begins with the modifier “In order to properly evaluate a patient’s state of mind
and gain informed consent prior to surgery.” This modifier logically should apply to the
modified noun “the operating physician,” as it is the operating physician who must evaluate a
patient’s state of mind and gain informed consent. In other words, "in order to do X" most
properly expresses the intention of the subject of the sentence, and so the subject should be
"the operating physician." The original sentence is incorrect, as the modifier is incorrectly
followed by “a substantial period of time” as opposed to “the operating physician.”
(A) This choice is incorrect as it repeats the original sentence.
(B) In this sentence, the modifier is followed by the compound subject “the operating
physician and the patient.” This choice incorrectly suggests that it is both the operating
physician and the patient that must evaluate the patient’s state of mind and gain informed
consent, as opposed to the physician alone. Also, the final phrase in the sentence, "thus
ensuring full awareness..." does not clarify exactly “whose” full awareness is ensured (the
awareness must clearly be the “patient's”).
(C) This choice places “the patient” immediately after the initial modifier, illogically and
incorrectly suggesting that the patient him or herself will evaluate the patient’s state of
mind. In addition, the pronouns "he or she" are ambiguous; they could refer to the patient or
to the physician.
(D) CORRECT. This choice places the proper subject, “the operating physician,” adjacent to
the opening modifier. Additionally, it is 100% clear that the “patient” is to be made fully aware
of the pros and cons of undergoing the surgical procedure.
(E) This choice correctly uses “the operating physician” as the subject of the sentence,
resolving the modifier issue. However, the pronouns “he or she” incorrectly refer to “the
operating physician,” suggesting that it is the physician, rather than the patient, who must be
made fully aware of the pros and cons of undergoing the surgical procedure.