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Because of illness, I need to go to the hospital for surgery. Do I have to have my family sign before the operation?
Your friend is an adult and can take full responsibility for his actions, so he can sign his name before the operation.

Except for special circumstances such as loss of consciousness, there is no requirement that adult surgery must be signed by family members.

It's better to talk to your family. After all, surgery is not a trivial matter.