Consent for mastoidectomy: a patient's perspective.

OBJECTIVES

The purpose of this study is to identify the difference between patients perspectives regarding the given information during the consenting procedure of mastoidectomy and the type of the provided information by the medical practitioners. This subject is becoming increasingly important because of the increase in the medico-legal litigation due to inadequate consenting process.

METHODS

Nineteen patients who had undergone mastoid surgery were asked to identify which risks of mastoid surgery they felt were important to be informed of prior to surgery. This was compared to 20 ENT consultants' answers on which risks they routinely discuss with patients preoperatively.

RESULTS

Our results show the 'average' patient would expect to be consented for all of the risks we asked about except for keloid scarring and altered taste, compared with the 'average' consultant who would discuss all risks routinely except for bleeding, intracranial complications and keloid scarring. The most obvious difference between doctor patient opinions is the topic of intracranial problems arising from surgery, 84.2% of patients would want to be warned about this but only 20% of surgeons routinely mention it (P-value < 0.001).

CONCLUSION

The main reasons for consultants omitting discussion of intracranial complications were their rarity and patients potentially finding it distressing. However, recent court rulings indicate that these reasons are invalid and not giving comprehensive consent may be indefensible.