Surgical treatment of brain tumors without informed consent - medical, organizational and legal aspect

Siedlecki Zygmunt, Gutkowska Agnieszka, Śniegocki Maciej. Surgical treatment of brain tumors without informed consent - medical, organizational and legal aspect. Journal of Education, Health and Sport. 2020;10(10):72-81. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.10.007

https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.10.007

https://zenodo.org/record/4104511

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© The Authors 2020;

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Received: 21.09.2020. Revised: 29.09.2020. Accepted: 18.10.2020.

Surgical treatment of brain tumors without informed consent - medical, organizational and legal aspect

Zygmunt Siedlecki¹, Agnieszka Gutkowska², Maciej Śniegocki¹

¹Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University in Toruń

²Department of Forensics, Institute of Criminal Law, Faculty of Law and Administration, University of Warsaw

Corresponding address:

Dr. med. Zygmunt Siedlecki Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery,

the Ludwik Rydygier Collegium Medicum in Bydgoszcz,

ul. Skłodowskiej-Curie 9

85-094 Bydgoszcz

tel.: + 48 606 302680

e-mail: siedlecki@cm.umk.pl

Abstract

Brain tumors are often manifested by mental disorders. Changes in personality, behavior and logical functions are often the dominant pathological symptoms in patients with brain tumors. There are also cases where brain tumors occur in patients with psychotic disorders or mental retardation and in these particular cases, they aggravate the already advanced mental disability. As a result, patients with brain tumors are often intellectually disabled and it is not possible to perform informed consent to treatment. In clinical practice, those patients who require neurosurgical treatment must give their informed consent, and when it is not possible, the judicial consent must be adjudicated. In urgent cases, medical decision on surgery is necessary in algorithm of life saving surgery, due to size of tumor and brain edema. We present the current state of knowledge and the facts about neurosurgical prcedures performed in patients with brain tumors without obtaining informed consent. We analyze the medical, legal and organizational status, pay attention to the nuances and the need for outstanding clinical experience in such a delicate matter. Clinical experience and legal awareness is essential for a qualifying neurosurgeon.

Key words: brain tumors, mental disorders, judicial consent