The commentary by Alden Harken, MD,1 in the October issue of the ARCHIVES highlighted several important aspects of surgical practice worthy of emphasis. Failure to provide informed consent could be considered playing God. Administration of radiation and 5-fluorouracil to a patient with node-positive pancreatic cancer is well tolerated and usually doubles the life expectancy that would accompany administration of vitamin B12 alone, with most of that time being of good quality.2 Patients must be given the choice: the physician can advise them, but the patient must consent. Certainly, the results of National Surgical Adjuvant Breast Project trials for breast cancer resection mentioned by Harken did not agree with the preferred treatment plan of many surgeons.
Douglass HO. A Patient's Right to Truly Informed Consent. Arch Surg. 2000;135(7):875-876. doi: