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Ethical Challenges with Awake Craniotomy for Tumor

Published online by Cambridge University Press:  02 December 2014

Brandon Kirsch  and
Mark Bernstein
Brandon Kirsch
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, and Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada
Mark Bernstein*
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, and Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada
*
Toronto Western Hospital, West Wing, 4W451, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
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Abstract

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Background:

Awake brain surgery is useful for the treatment of a number of conditions such as epilepsy and brain tumor, as well as in functional neurosurgery. Several studies have been published regarding clinical results and outcomes of patients who have undergone awake craniotomy but few have dealt with related ethical issues.

Objective:

The authors undertake to explore broadly the ethical issues surrounding awake brain surgery for tumor resection to encourage further consideration and discussion.

Methods:

Based on a review of the literature related to awake craniotomy and in part from the personal experience of the senior author, we conducted an assessment of the ethical issues associated with awake brain tumor surgery.

Results:

The major ethical issues identified relate to: (1) lack of data; (2) utilization; (3) conflict of interest; (4) informed consent; (5) surgical innovation; and (6) surgical training.

Conclusion:

The authors respectfully suggest that the selection of patients for awake craniotomy needs to be monitored according to more consistent, objective standards in order to avoid conflicts of interest and potential harm to patients.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 1 , January 2012 , pp. 78 - 82
Copyright
Copyright © The Canadian Journal of Neurological 2012

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