Consent, Benefit, and Risk in Anaesthetic Practice

Patient expectations regarding involvement in their own healthcare have increased dramatically over the past few years. It is no longer acceptable for the doctor to dictate treatment; patients demand information regarding treatment options, and input into the selection of the most appropriate treatment plan. This is evidenced by court decisions that have upheld patient litigation on the basis that inadequate information was given to them before treatment, and that they were unaware of risks of complications which subsequently materialized. While these complaints are more typical against surgeons, similar claims are likely in relation to anaesthetic procedures. Anaesthesia is no longer considered a non-negotiable aspect of surgical care, and anaesthetists need to be aware of current issues surrounding provision of information concerning risks and benefits of anaesthesia, and obtaining consent.

This book provides useful, up-to-date information for anaesthetists and medico-legal practitioners regarding consent, risk and benefit in anaesthesia. It begins with the general principles of consent, and how risks and benefits might be conveyed. This is followed by an exploration of the clinical contexts in which consent is needed, covering obstetrics, emergency surgery, and critical care. Special considerations such as children, high risk patients, and the incapacitated/incompetent adult are also identified. Section 3 covers specific risks and benefits associated with anaesthesia. These are referenced by phsyiological system and and anaethetic technique, and illustrated with case scenarios to provide the reader with accessible information that is relevant to daily practice. The book concludes with valuable contributions from those outside anaesthesia: the legal perspective, and that of the patient. Edited by experts in medico-legal studies and anaesthesia, this first book in this complex field will prove invaluable for those dealing with the increasing demands of consent, benefit, and risk in anaesthesia.

About the Author:
Jonathan Hardman is a clinical academic in anaesthesia at the University of Nottingham. He trained in Nottingham and took up his first clinical academic post there in 1996. His interests include pathophysiological modelling and perioperative risk and outcome. He is a member of the editorial boards of two journals, the Honorary Secretary of the Anaesthetic Research Society and the holder of the Royal College of Anaesthetists' Macintosh Professorship. Iain Moppett is a clinical academic in anaesthesia at the University of Nottingham. He trained in Cambridge and Nottingham and took up his first clinical academic post there in 2000. His interests include computational modelling, perioperative risk prediction and consent. He is a member of the editorial board of EIDO Healthcare, a medical information and consent company and was on the AAGBI working party on consent. Alan Aitkenhead became Professor of Anaesthesia in Nottingham in January 1989. His principal research interests relate to the influence of anaesthetic and analgesic drugs on the outcome of surgery of the colon, memory and awareness during general anaesthesia, and safety of anaesthesia. He is author and co-editor of a number of books, including Textbook of Anaesthesia, now in its fifth edition. He is currently Head of the School of Medical and Surgical Sciences at the University of Nottingham and Chair of the Nottingham and East Midlands School of Anaesthesia. He is a member of the Council of the Medical Defence Union. Internationally, he was a founder member of the European Society of Anaesthesiologists and was its President from 1996 to 1999, and he is Chairman of the Editorial Board of the European Journal of Anaesthesiology.