Two recent presentations at the
2016 Annual Meeting of the American Society for Bioethics and Humanities in Washington,
DC – offered within just a couple of hours of each other – had a similar theme
but approached the issue from different angles. The first presentation was a
case review by David Kappel, MD, a surgeon at the University of West Virginia,
and Valerie Satkoske, MSW, PhD, a bioethics professor at the University of West
Virginia Center for Bioethics and Health Law. The case involved a 75-year-old-man
admitted for surgery. Unfortunately, following the surgery, he was delirious.
The delirium continued for several days. He had to be restrained and fed with a
nasogastric tube. The situation was very upsetting to his family; they were
completely taken aback by this complication. The delirium was so unexpected and
surprising that the family wondered whether or not the patient would have
agreed to the surgery if he had fully understood that the extended delirium
might result. The title of this presentation was: “You Should Have Told Me!
Struggling to Meet the Spirit of Informed Consent.” As one can imagine, the
presenters asked if information about the possibility of an extended delirium
should have be included as a part of the informed consent process. The delirium
was not part of the patient’s and family’s expectations. Of course, even with a
more extensive, informed consent process, the family still may have not been
fully prepared to deal with the complication anyway. Perhaps the answer turns
more on the likelihood of the complication arising in this patient’s case given
the particulars and context?
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.