Risk acceptance and risk aversion: patients' perspectives on lung surgery

Thoracic Surgery Clinics
S Cykert

Abstract

Patients express risk aversion toward surgery, particularly if surgery can lead to lifelong debility and loss of independence. When faced with a guarantee of progressive lung cancer and no alternatives for cure, however, patients are willing to take extremely high risks of postoperative complications and surgery-related death. This result occurs because risk aversion toward unrelenting cancer death supersedes patients' risk attitudes toward almost all other health states. By adding conditions such as misunderstanding of prognosis, diagnostic uncertainty, a patient's denial of diagnosis, an actual alternative cure such as radiation therapy, or a perceived alternative cure such as prayer, decisions can be shifted so that risk aversion to surgery can predominate. In practical terms, the following statements can be made: 1. For patients who surely have operable stage I or stage II non small cell lung cancer, if patient risk preferences are taken seriously, the pulmonary function level and comorbidities that are acceptable for the offer of surgical care probably need to be liberalized. Patients with short life expectancies because of advanced age or comorbid illness and patients with severe preoperative functional debility (eg, bed-...Continue Reading

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Citations

Nov 11, 2005·World Journal of Surgical Oncology·Ronald A M DamhuisWillem S Meijer
Nov 3, 2007·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Hes A P BrokxMarinus A Paul
Oct 23, 2012·Thoracic Surgery Clinics·Sabha Ganai, Mark K Ferguson
Aug 4, 2010·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Kathryn A AtchisonMelanie W Gironda
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Apr 12, 2008·Thoracic Surgery Clinics·Gonzalo Varela, Nuria M Novoa
Jan 14, 2010·Thoracic Surgery Clinics·Holly M Holmes
Oct 14, 2005·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Ronald DamhuisHenrik Møller
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May 27, 2015·Multiple Sclerosis and Related Disorders·Robert J FoxGary Cutter
Aug 21, 2016·Journal of Cancer Education : the Official Journal of the American Association for Cancer Education·Virginia SunRuth McCorkle
Feb 14, 2018·Arthritis Care & Research·Betty HsiaoLiana Fraenkel
Mar 24, 2021·Archivos de bronconeumología·David Gómez de AntonioFlorentino Hernando Trancho

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