Should surgeons operate if they find something else wrong with you?

Most surgeons believe they should act if they unexpectedly find something wrong, like a tumour, during an unrelated operation. Photo / 123RF

Surgeons who come across a tumour or leaky blood vessel in the middle of another elective surgery are often prepared to treat it - even without patient consent, new research from Otago University has found.

And a second Otago paper found the public agrees they should operate if they find something abnormal, especially if it threatens the patient's health and is a low-risk procedure.

But surgeons could risk being disciplined if they go ahead, because patients are rarely asked for consent to operate on an incidental finding before surgery.

The researchers argue that medical consent forms should include a clause giving surgeons permission to act if they see something unusual.

The two papers, published in today's New Zealand Medical Journal, are thought to be the first international studies where surgeons, patients and the public are asked their views on incidental findings during surgery.

One study looked at current practice when surgeons are faced with an incidental finding; the second looked at attitudes of the public and patients.

The public (331 respondents) and patients' views (368) were similar to the surgeons' (151), with most preferring to proceed with treatment in 75 per cent of the hypothetical scenarios.

Most supported a clause within the consent form that would trigger a discussion of incidental findings during the patient consent process.

But many consent forms used in New Zealand contain no such clause.

Otago University Professor Andrè van Rij wants medical consent forms to include a clause that gives surgeons permission to operate if they find something unexpected. Photo / Supplied

Lead researcher Andre van Rij, University of Otago Ralph Barnett Professor of Surgery, hoped the research would lead to changes in the consent process.

"Something needs to be done about it because it would help patients understand the system better and it would also help surgeons because they are caught in a dilemma," he said.

In New Zealand, such treatment may breach the Code of Health and Disability Services Consumers' Rights. Surgeons may also be subject to disciplinary proceedings.

Most surgeons and trainees interviewed agreed that under certain conditions, with modest risks and clear benefits, treating the finding would be acceptable. Men were more likely than women to find this acceptable.

However the researchers raised concerns about a few surgeons who would proceed without consent even when the treatment was higher risk and of less benefit.