Incidental findings during a surgical procedure-patient and public perspectives.

Autor:	van Rij AM; Professor, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin., Thomas J; Assistant Research Fellow, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin., McKenzie R; Medical Student, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin., Diong J; Assistant Research Fellow, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin., Frizelle F; Professor, Head of Department, Department of Surgery, University of Otago, Christchurch., Snelling J; Research Fellow, Bioethics Centre, University of Otago, Dunedin., Anderson L; Associate Professor, Bioethics Centre, University of Otago, Dunedin.
Jazyk:	angličtina
Zdroj:	The New Zealand medical journal [N Z Med J] 2018 Feb 02; Vol. 131 (1469), pp. 20-31. Date of Electronic Publication: 2018 Feb 02.
Abstrakt:	Aim: During a surgical procedure, incidental findings (IF) may be found and often the immediate treatment is in the patient's best interest. Due to the nature of IFs, specific patient consent cannot be obtained under such circumstances. The dilemma is whether the surgeon should proceed or delay until consent is obtained, as there are significant ethical and legal implications. Following an earlier study of surgeons' preferences for IF management, this report investigates patient and public preferences. Method: A questionnaire presented hypothetical scenarios involving IFs and samples of patients and public respondents reported their preference to proceed with treatment or have their surgeon wait to obtain consent. Opinion was sought regarding factors influencing their decisions and if general surgical consent procedures should cover IFs. Results: A sample of 331 respondents from the general public and 368 elective surgery patients were surveyed. Results showed an overall preference to proceed with treatment in 75.1% of the hypothetical scenarios, which increased with IF severity and decreased with procedural risk. Thematic analysis of open-ended questions revealed a number of factors influencing preferences with avoidance of further surgery being most common. Results showed most respondents preferred for information provided in general consent forms though not all were comfortable about this. Conclusion: Patient and public preferences to proceed with treatment in hypothetical scenarios were generally consistent with surgeons' reported practice when faced with IFs. The data suggest that an IF clause in the consenting process could help surgeons make clinical decisions best aligned with individual patients' preferences. Competing Interests: Nil.
Databáze:	MEDLINE
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