Unknown Unknowns: Surgical Consent During the COVID-19 Pandemic

Atención de la urgencia quirúrgica durante la pandemia COVID-19. Recomendaciones de la Asociación Española de Cirujanos

“…La evaluació n de cada paciente debe ser extremadamente minuciosa y realizarse de manera conjunta por un equipo pluridisciplinar que incluya a anestesió logos así como a los responsables de las unidades de cuidados intensivos (UCI). Es por esto que, ademá s, la ponderació n de los aspectos é ticos en estos casos es clave 33 . Si bien en algunos centros existen documentos que de modo explícito establecen un «techo terapé utico», esta medida, aunque recomendable, no está disponible de manera generalizada.…”

Patient Counseling in Plastic Surgery during Coronavirus Disease 2019

“…Finally, resource shortages may alter postoperative care, both in cases of successful surgery and when complications arise. 3 We agree on the importance of informing patients of these issues. However, there are risks specific to plastic surgery that must also be addressed (Table 1 ).…”

“…A recent report by Bryan et al 3 highlighted several considerations for surgical patients during the pandemic (Table 1 ). First, there is a lack of evidence demonstrating how infected patients tolerate routine procedures, including physiologic response to surgery and anesthesia.…”

“…This has the added benefit of protecting healthcare personnel who come into contact with the patient. Additionally, as noted by Bryan et al, 3 the use of advanced directives and living wills is encouraged, given the high degree of uncertainty surrounding surgery and COVID-19. 3 Finally, application of sound clinical judgment, shared decision-making, and a patient-centered approach will facilitate improved care, particularly where clinical evidence is lacking.…”

An Exit Strategy for Resuming Nonemergency Neurosurgery after Severe Acute Respiratory Syndrome Coronavirus 2: A United Kingdom Perspective

“…However, the mortality rate for COVID-19enegative patients undergoing elective surgery during a decline phase of the virus remains unclear and is likely to be much lower. Nevertheless, the potential increase in morbidity and mortality for patients choosing to undergo routine surgery at present should be clearly explained as a part of the informed consent process, 21 especially for black and Asian minority ethnic groups. 22,23 Other known risk factors for serious COVID-19 infection include older age, cardiovascular disease, chronic respiratory disease, diabetes, and obesity.…”