caa a22 4500 606216618 CHVBK 20210128101104.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s00701-014-2304-5 doi (NATIONALLICENCE)springer-10.1007/s00701-014-2304-5 Primo non nocere or maximum survival in grade 2 gliomas? A medical ethical question [Elektronische Daten] [Jannick Brennum, Carolina Maier, Kerstin Almdal, Christina Engelmann, Mickey Gjerris] Background: Maximum safe resection is the "gold standard” in surgical treatment of grade 2 gliomas (G2Gs), aiming to achieve maximal survival benefit with minimal risk of functional deficit. Objective: To investigate the attitude of patients and experts towards more extensive surgery with a trade-off between neurological function and survival time. Methods: Eight patients and seven experts participated in semi-structured focus group interviews. Results: Both patients and experts accepted the premise of balancing neurological function versus longevity. Some patients would accept an increased risk of permanent neurological deficits in order to obtain a chance of increased survival. There was a significant variance in what constituted "quality of life” both between patients and for the individual patient over time. Conclusions: In important life-changing decisions there is no "one size fits all”. We find that it is ethically acceptable to offer more extensive surgery than is possible within the concept of maximal safe surgery as a treatment option, when balancing the principles of beneficence, non-maleficience, autonomy and justice supports the decision. At the same time it must be remembered that even when the patients have made a well-informed decision, some will regret it. In that situation it will be our job as healthcare professionals to support them and help carry some of this burden. Springer-Verlag Wien, 2014 Autonomy nationallicence Awake surgery nationallicence Ethics nationallicence Longevity nationallicence Low-grade glioma nationallicence Quality of life nationallicence G2G : Grade 2 glioma nationallicence Brennum Jannick Copenhagen Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 København Ø, Copenhagen, Denmark aut Maier Carolina Danish Research Centre for Patient Support and Empowerment, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark aut Almdal Kerstin Copenhagen Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 København Ø, Copenhagen, Denmark aut Engelmann Christina Copenhagen Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 København Ø, Copenhagen, Denmark aut Gjerris Mickey Department of Food and Resource Economics, Faculty of Science, University of Copenhagen, Copenhagen, Denmark aut Acta Neurochirurgica Springer Vienna 157/2(2015-02-01), 155-164 0001-6268 157:2<155 2015 157 701 https://doi.org/10.1007/s00701-014-2304-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-014-2304-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Brennum Jannick Copenhagen Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 København Ø, Copenhagen, Denmark aut NATIONALLICENCE 700 1- Maier Carolina Danish Research Centre for Patient Support and Empowerment, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark aut NATIONALLICENCE 700 1- Almdal Kerstin Copenhagen Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 København Ø, Copenhagen, Denmark aut NATIONALLICENCE 700 1- Engelmann Christina Copenhagen Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 København Ø, Copenhagen, Denmark aut NATIONALLICENCE 700 1- Gjerris Mickey Department of Food and Resource Economics, Faculty of Science, University of Copenhagen, Copenhagen, Denmark aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/2(2015-02-01), 155-164 0001-6268 157:2<155 2015 157 701