Informed Consent in Endoscopic Sinus Surgery: The Patient Perspective

• Published in: The Laryngoscope 2005-03, Vol.115 (3), p.492-494
• Main Authors: Wolf, Jeffrey S., Chiu, Alexander G., Palmer, James N., O'Malley Jr, Bert W., Schofield, Kimberly, Taylor, Rodney J.
• Format: Article
• Language: English
• Subjects: Attitude to Health; Bioethics; Biological and medical sciences; Endoscopy; Female; FESS; functional endoscopic sinus surgery; Humans; Informed Consent; Intraoperative Complications; Male; Medical sciences; Middle Aged; Otorhinolaryngology. Stomatology; Paranasal Sinuses - surgery; Patients - psychology; Postoperative Complications; prudent patient standard; prudent physician standard; Risk; Surveys and Questionnaires; Truth Disclosure
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/01.mlg.0000157835.69121.f8

Objectives: To understand patient expectations during the informed consent process for functional endoscopic sinus surgery (FESS). Study Design: Multi‐institutional, cross‐sectional survey design. Methods: Anonymous surveys were administered to patients in two tertiary academic centers with a chief complaint relating to “allergy and sinus” problems. Patients completed an eight‐item questionnaire that assessed both the nature and the level of risks that they wished to be informed of prior to FESS. Results: Three hundred eighty‐nine surveys were returned. Sixty‐nine percent of patients wished to be informed of complications that occur as infrequently as 1 in 100 cases, regardless of severity. Ninety percent of patients wanted to know of a risk that occurred as frequently as 1 in 10 cases. Patients also reported whether or not they wished to be told in detail about specific complications during the informed consent process, regardless of their infrequency. Affirmative responses were as follows: 83% for cerebrospinal fluid leak and orbital injury, 81% for infection, 76% for revision surgery, 74% for impairment of smell, 73% for bleeding and myocardial infarction, 72% for cerebrovascular accident, and 58% for scarring. Conclusions: Patients wanted to be informed about severe FESS complications at a higher rate than physicians previously surveyed, even if the incidence is low. This study, combined with our previous examination of the physicians' perspective, highlights that there may be a discrepancy between what the physician and the patient believe are priority topics during the informed consent process.