Informed Treatment Consent and Refusal in Advanced Endonasal Surgery: The Ethical Dilemma of Olfaction Sacrifice in Surgery for Chronic Rhinosinusitis with Polyposis

Authors

  • João Subtil Serviço de Otorrinolaringologia. Hospital Cuf Descobertas. Lisboa. Portugal.
  • João Pedro Araújo Serviço de Otorrinolaringologia. Hospital Cuf Descobertas. Lisboa. Portugal.
  • José Saraiva Serviço de Otorrinolaringologia. Hospital Cuf Descobertas. Lisboa. Portugal.
  • Alberto Santos Serviço de Otorrinolaringologia. Hospital Cuf Descobertas. Lisboa. Portugal.
  • Paulo Vera-Cruz Serviço de Otorrinolaringologia. Hospital Cuf Infante Santo. Lisboa. Portugal.
  • João Paço Serviço de Otorrinolaringologia. Hospital Cuf Infante Santo. Lisboa. Portugal.
  • Diogo Pais Faculdade de Ciências Médicas. Universidade Nova de Lisboa. Lisboa. Portugal.

DOI:

https://doi.org/10.20344/amp.5858

Keywords:

Ethics, Medical, Informed Consent, Nasal Polyps/surgery, Olfaction Disorders, Otorhinolaryngologic Surgical Procedures, Treatment Refusal.

Abstract

Introduction: Olfaction is frequently affected in chronic rhino-sinusitis with polyposis and has been recognised to have important impact on quality of life. Surgical resolution on cases of maximal medical therapy failure is an option to relieve symptoms, with debates as to how extensive surgery should be. A more radical approach will achieve better disease control with less relapse, but can also compromise olfaction. This decision about a more radical surgical approach should be shared with the patient. Thorough informed consent regarding disease control and hyposmia should be taken.
Material and Methods: Literature review and consultation with a board of experts.
Results and Discussion: We propose some elements to be included in the informed consent discussion, in order to broadly address the surgical limitations regarding anosmia as a frequent complaint, as well as the different options and their associated consequences.
Conclusion: Radical surgery decision making should be shared with the patient and the informed consent should be as thorough as possible regarding disease control and hyposmia resolution.

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Author Biography

João Subtil, Serviço de Otorrinolaringologia. Hospital Cuf Descobertas. Lisboa. Portugal.

Assistente Hospitalar de Otorrrinolaringologia

Published

2015-07-10

How to Cite

1.
Subtil J, Araújo JP, Saraiva J, Santos A, Vera-Cruz P, Paço J, Pais D. Informed Treatment Consent and Refusal in Advanced Endonasal Surgery: The Ethical Dilemma of Olfaction Sacrifice in Surgery for Chronic Rhinosinusitis with Polyposis. Acta Med Port [Internet]. 2015 Jul. 10 [cited 2024 Mar. 28];28(4):513-6. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/5858

Issue

Section

Review Articles