[Respect for autonomy. How much do patients want to know in order to make decisions?]

Informed consent should be the expression of active participation of patients in the decision-making process. It is an application of the ethical principle of respect for patient autonomy. However, there are some concerns about the direct extrapolation of the Anglo-saxon concept of autonomy into other societies which could impose an unwanted level of patient participation. The objective of this study was to explore the quantity and quality of information that Argentine patients want to receive before making a decision about a surgical procedure. Among 200 patients possibly scheduled for elective surgery, more than 80% preferred to know all the possible alternatives of treatment and all the advantages and disadvantages of each alternative. Less than 20% considered that the patients themselves should make the decision regarding surgery after learning about all the risks and benefits. Seventy one percent of patients preferred to receive the information with their families in order to make a joint decision with them. Seventeen percent of patients preferred not knowing if there was a possibility they could die during surgery. These results suggest that in the current medical environment, one previously dominated in Argentina by a tendency towards beneficient paternalism on the part of physicians and surgeons, patients want to be extensively informed about risks, benefits, and procedural alternatives before electing to undergo a surgical procedure. Patient preferences regarding how family members should be involved in the decision-making should be elicited. Careful consideration is warranted, however, in the way health care providers might address risks of procedure-related death so that subjects who do not want to know about this risk can be identified.