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Retrait de consentement et chirurgie éveillée : illustration et enjeux éthiques

  • Michel Wager (a1), Foucaud Du Boisgueheneuc (a2), Coline Bouyer (a2), Claudette Pluchon (a2), Véronique Stal (a3) and Roger Gil (a4)...
Résumé
Contexte

Le développement au cours des deniers années des interventions neurochirurgicales sous anesthésie locale, en particulier dans le champ neuro-oncologique, rend possible la question d’une éventuelle révocation per opératoire du consentement du patient à la procédure chirurgicale.

Observation

Les auteurs décrivent la révocation de son consentement par un patient au cours de l’exérèse chirurgicale d’un gliome de bas grade fronto-temporo-insulaire droit.

Discussion

Les aspects spécifiques aux conditions de révocation du consentement dans le contexte particulier de la chirurgie sous anesthésie locale sont discutés. La possibilité d’un pacte d’Ulysse est proposée et discutée.

Conclusions

Les interventions chirurgicales en condition éveillée créent un contexte particulier en ce qu’une révocation du consentement per opératoire devient possible. Dans ces conditions, l’information préopératoire pourrait aussi aborder avec le malade la question de la conduite à tenir au cas où il serait amené à solliciter un retrait de consentement lors de son réveil per opératoire.

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Copyright
Corresponding author
Correspondence to: Michel Wager, Service de Neurochirurgie, Centre Hospitalier Universitaire de Poitiers, 2 Rue de La Milétrie, BP 577, 86021 Poitiers Cedex, France. Email: m.wager@chu-poitiers.fr
References
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Canadian Journal of Neurological Sciences
  • ISSN: 0317-1671
  • EISSN: 2057-0155
  • URL: /core/journals/canadian-journal-of-neurological-sciences
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