Informed Consent in the Operating Room:
Case 2 Discussion
This request to curtail discussion of risks is not originating with the patient. To avoid discussion for the purpose of improving the likelihood that the patient will cooperate with bone marrow harvest not only carries some mistaken assumptions about the effects of risks discussions, but it "uses" the patient to meet the ends of another individual, rather than to further his own goals, a distinctly unethical practice.
Since the patient is anxious, it is reasonable to offer to discuss risks with him, but inform him that he has the choice to not have a detailed discussion if he thinks it might unduly stress him.
More importantly, a well-done discussion of risks with this patient can be reassuring, and serve to decrease his anxiety about the upcoming procedure. The patient may be suffering from unreasonable fears about the risks of the procedure. Since the patient is healthy, anesthesia and procedure risks are minimal. He can be reassured that the procedure presents him with less risk than many things he does every day without much concern--such as driving a car to his appointment in your office.
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