Anaesthetists do not need separate consent before surgery

British Medical Journal, July 17, 1999 by Roger Dobson

New guidelines on obtaining consent for anaesthesia recommend that consent from patients specifically for a general anaesthetic is not needed. The guidelines, produced by a working party of the Association of Anaesthetists of Great Britain and Ireland, say that there is no virtue in getting the patient to sign a separate consent form.

"The Department of Health recommends that written consent should be obtained for general anaesthesia," says the report. "However the working party sees no reason why it should be recommended that written consent should be obtained specifically for general anaesthesia when it is agreed it is unnecessary for local or regional anaesthesia."

But the guidelines do recommend that anaesthetists should make a record of what has been discussed and agreed with the patient, including any material risks that have been explained. They do not support the idea of a checklist of possible risks, pointing out that the anaesthetist must exercise clinical judgment in discussing risks.

The report warns that practitioners should be aware that a blank consent form left in clinical notes may lead to a suggestion that the clinician had disregarded the practice normally followed in that hospital.

The working party, chaired by Professor Alan Aitkenhead, was set up to look at a number of issues surrounding consent and to clear up any confusion.

"It is clear that considerable confusion exists among anaesthetists regarding their requirements in obtaining consent for anaesthesia and that has led to wide variations in practice between departments and among individuals within each department," says the report.

It adds that issues surrounding consent are increasingly being raised in civil claims alleging negligence by anaesthetists.

Information and Consent for Anaesthesia is available from the Association of Anaesthetists of Great Britain and Ireland, 9 Bedford Square, London WC1B 3RA.