Abstract：
BACKGROUND:Although experts in ethics and law prescribe autonomous decision making as an essential component of informed consent to operative treatment, patients with esophageal cancer told us in a previous study that they preferred to entrust decision making to their caregivers in the context of life-threatening illness. The purpose of this study was to describe the patients' perspective on the process of informed decision making and consent to operative treatment in the context of a less frightening illness and intervention. STUDY DESIGN:Face-to-face interviews with 33 patients recovering from elective cholecystectomy for cholelithiasis were conducted at Toronto General Hospital in Ontario, Canada. The views of patients were analyzed using a qualitative approach. RESULTS:Patients described a spectrum of initial attitudes toward operative treatment ranging from profound distrust to unquestioning faith. Important factors influencing the decision to accept cholecystectomy included increasingly intolerable symptoms and fear of complications of the disease. Patients managed their doubts and fear by various means, without fully resolving them. CONCLUSIONS:In the context of symptomatic chronic cholelithiasis, pathways to consent for operative treatment originated at diverse, culturally determined starting points. Patients work their way through the decision process along many paths. Some rely on gathering information, but eventually all set aside unresolved residual doubts and fears, enabling a leap to trust and a decision to act.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
McKneally MF,Ignagni E,Martin DK,D'Cruz Jdoi
10.1016/j.jamcollsurg.2004.02.021keywords:
subject
Has Abstractpub_date
2004-07-01 00:00:00pages
51-7issue
1eissn
1072-7515issn
1879-1190pii
S1072-7515(04)00286-8journal_volume
199pub_type
杂志文章abstract：BACKGROUND:The efficacy and safety of magnetic sphincter augmentation (MSA) with the LINX device (Torax Medical) has been reported in several short-and long-term studies, rivaling historic results of laparoscopic Nissen fundoplication (LNF), but with fewer side effects. However, there have been no studies comparing pat...
journal_title：Journal of the American College of Surgeons
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abstract：BACKGROUND:Wedge or other nonanatomic hepatic resections, performed in an attempt to spare functional parenchyma, often are not accomplished with clear resection margins and may be complicated by hemorrhage from the depth of the resection. STUDY DESIGN:The current study describes a technique of cryoassisted hepatic re...
journal_title：Journal of the American College of Surgeons
pub_type： 临床试验,杂志文章
doi：
更新日期：1995-02-01 00:00:00
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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abstract：BACKGROUND:Oxandrolone, an anabolic agent, has been administered for 1 year post burn with beneficial effects in pediatric patients. However, the long-lasting effects of this treatment have not been studied. This single-center prospective trial determined the long-term effects of 1 year of oxandrolone administration in...
journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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更新日期：1994-07-01 00:00:00
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journal_title：Journal of the American College of Surgeons
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更新日期：2009-11-01 00:00:00
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pub_type： 杂志文章
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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