Information and consent for anaesthesia: a postal survey of current practice in Great Britain

Abstract

SummaryA postal questionnaire survey was sent to Royal College of Anaesthetists' tutors in Great Britain and Northern Ireland to gain insight into current practice with regard to information and consent for anaesthesia. Details of consent practice in three specific areas were requested: anaesthesia in general, teaching medical students during anaesthesia and obstetric anaesthesia. Replies were received from 218 tutors (77%). Of these, 72% of departments had a policy on consent for anaesthesia that was in accordance with The Association of Anaesthetists of Great Britain and Ireland guidelines oǹ Information and Consent for Anaesthesia'. We identified three areas of concern. Firstly, almost a third of departments (27%) had no policy on consent for anaesthesia. Second, only 18% of relevant departments obtain specific consent for the teaching of medical students on anaesthetised patients. Third, 1 year after publication of the guidelines, 17% of obstetric anaesthetic units, despite stating an intention to alter their departmental policy based on the Association's recommendations, had not yet implemented any changes.

Informed consent for anesthesia: survey of current practices in Japan

“…However, according to Watkins et al, only 4.5% of those anesthetic departments used separate anesthetic consent forms. They reported that 70% of departments surveyed documented oral consent on the anesthetic chart, and 72% of departments thought separate anesthetic consent forms were unnecessary [8]. On the contrary, White and Baldwin argued that anesthesiologists should obtain separate, written consent for anesthesia.…”

“…Watkins et al reported that 27% of anesthetic departments in the United Kingdom had no departmental policy for consent to anesthesia. They pointed out that inconsistencies might provide grounds for legal challenge [8]. Similarly in Japan, anesthetic departments need to standardize their explanation and promote better communication between anesthesiologists and surgeons.…”

What a signature adds to the consent process

“…Although it is legally not mandatory before the operative intervention, it becomes a statutory requirement when biomedical research, organ procurement, or medically assisted reproduction is involved [19]. Furthermore, certain centers have begun to seek specific consent for general anesthesia [20] and interventional radiology [21] separate from that obtained by the surgical team. This move has been inspired primarily by medicolegal concerns [22], notwithstanding that the requirement for the former has been specifically rejected by the courts in these islands.…”

Consent for regional anaesthesia in the United Kingdom: what is material risk?

“…A recent study showed that only 57% of anaesthetic departments surveyed had a written policy for explanation of pain relief options in labour. 13 The OAA leaflet and video 'Pain relief in labour' provide an important source of information for parturients. 14 They also contain some risk information regarding regional anaesthesia.…”