Incidental findings during a surgical procedure-current practice and ethical implications

Area of Science:

• Surgical Practice
• Medical Ethics
• Informed Consent

Background:

• Unexpected abnormalities, termed incidental findings (IFs), can be discovered during elective surgery.
• Immediate treatment of IFs may benefit patients, but specific consent is often lacking.

Purpose of the Study:

• To investigate current surgical practices regarding incidental findings.
• To explore surgeons' views on informed consent for treating unexpected pathologies.

Main Methods:

• An online survey was distributed to surgeons and trainees in New Zealand.
• Respondents analyzed hypothetical scenarios involving IFs and indicated treatment decisions.
• Surgeons' opinions on influencing factors and consent clauses were gathered.

Main Results:

• 33.6% of surgeons responded to the survey.
• Treatment of IFs was more likely for significant findings, low-risk procedures, and with prior consent.
• 86% of respondents supported a consent form clause for discussing IF treatment.

Conclusions:

• Surgical decisions on IFs generally align with good practice, though some variations exist.
• A majority of surgeons advocate for consent forms that prompt discussion of incidental findings.
• Integrating IF discussion into the consent process is widely supported.