How much do we need to explain to our patients to properly gain their consent? The answer is as much as they can understand given their ability to make sense of the main points that are outlined below. The surgeon may feel that mentioning complications to the patient will frighten them unnecessarily, but it is possible to mention even serious complications in the right context without causing alarm, and it is our duty to do so. For example, one might say "Serious complications involving the eye have been described but these are rare and we will do everything that we can to look after you and avoid them." Patients need to:
• Understand their diagnosis.
• Understand the context of their symptoms in the light of their diagnosis. For example, a patient who has persistent postnasal drip and who has late-onset asthma and polyps needs to understand that while surgery can aerate their sinuses, remove the bulk of the polyps to help breathing, and reduce the surface area that produces polyps, it will not stop all the mucus production from the lining of the sinuses. The mucus production is due to generalized inflammation of the mucosa of the nose that is like asthma, and surgery will not stop it.
• Understand the principles of the surgical procedure, the "thinking" behind the reason for operating, and the main technical aspects of the procedure.
• Be informed about complications that occur with any frequency as well as about severe ones—even if they are rare.
• Be informed about what they can expect in the postoperative period: the healing process, the symptoms they can expect, the medical therapy they should take, and the need for time off work.
Patient information leaflets support what has been said during the consultation. The patient information leaflets that we use are included as an Appendix at the end of this book. You may copy these for your patients.
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