Case Report
Informed Consent in Otolaryngologic Surgery: Case Scenario
from a Nigerian Specialist Hospital
O. A. Afolabi,
1,2
J. O. Fadare,
3
and O. T. Ajiboye
4
1
Department of Ear, Nose, and Troat, University of Ilorin, PMB 1515, Ilorin 240213, Nigeria
2
University of Ilorin Teaching Hospital, PMB 1459, Ilorin 240212, Nigeria
3
Department of Pharmacology, Ekiti State University, PMB 5363, Ado-Ekiti 360221, Nigeria
4
Accident and Emergency Department, University of Ilorin Teaching Hospital, PMB 1459, Ilorin 240212, Nigeria
Correspondence should be addressed to J. O. Fadare; jofadare@gmail.com
Received 27 March 2014; Revised 23 June 2014; Accepted 26 June 2014; Published 8 July 2014
Academic Editor: Andrea Gallo
Copyright © 2014 O. A. Afolabi et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Informed consent is a foundational concept necessary for ethical conduct of clinical research and practice. It is a technical tool that
shifs the autonomy to decide whether a medical procedure should be performed—from the doctor to the patient. However there
is an ongoing discussion in bioethical circles on the level of comprehension of the informed consent process by the patients and
research participants. We present this case vignette and the discussion aferwards to explore the question of to what extent a patient
comprehends the information given to him/her before a surgical procedure is carried out. In other words, the question being asked
here is how informed is informed consent in the context of oto-laryngological practice.
1. Background
Te acquisition of medical information before undergoing
any surgical operation is a complex process. It is increasingly
being recognized that the patient plays an active role rather
than just passively accepting doctors’ advice [1, 2]. Studies
on this subject have largely yielded nonsatisfactory results
[3]. Informed consent itself is a technical tool that shifs the
autonomy to decide whether a medical procedure or clinical
research should be performed—from the doctor to the
patient [4]. Increase in the awareness of diferent websites has
increased nonmedical sourcing of information being utilized
by patients [5]. In this era of increased patient expectations,
the medical profession is trying to optimize information
delivery by using patient decision sofware [6] and printed
information sheets (in up to 25% of ENT departments) [7]
and increasingly by shifing the role of provision of patient
information to more senior members of the team [8, 9].
Some studies in the United States have argued that the federal
government poses an actual barrier to informed consent
concerning oral contraceptives and induced abortion [10].
Te understanding of informed consent among patients in
developing countries like Nigeria depends on the educational
level, extended family culture, rural-urban dichotomy, and
religion [11]. Te purpose of the study was to contribute to
the debate on the level of comprehension and information
retention during the process of informed consent using a
case vignette from otolaryngological surgical practice. To our
knowledge, this is the frst report on informed consent report
from north-central Nigeria.
2. Case Scenario
Patient AA is a 26-year-old female undergraduate who was
seen in ENT clinic in a Nigerian specialist hospital with
complaints of nasal discharge, nasal obstruction, excessive
sneezing, mouth-breathing, and occasional cough.
Physical examination revealed a young lady who was not
pale, anicteric, and afebrile. Examination of the nasal cavity
revealed normal shaped nose and no skin changes. Tere was
an obvious pale, multiple polypoid bluish mass partially oblit-
erating both nasal cavities which did not bleed on contact.
Te mass arises from the lateral wall; both turbinates appear
bluish and engorged with partial patency. Neck examination
Hindawi Publishing Corporation
Case Reports in Otolaryngology
Volume 2014, Article ID 120985, 4 pages
http://dx.doi.org/10.1155/2014/120985