Clinical Case Database / Category: Patient Management

Competence, complications & consent in anaesthesia

Publication details

Sophie Burns, Dr MDD Bell MPhil FRCA FFICM
Foundation Years Journal, volume 9, issue 8, p.24 (123Doc Education, London, September 2015)

Abstract

Anaesthesia carries the potential to cause death or serious injury, risks which the patient should be made aware of. This paper explores contemporary standards of informed consent and the difficulties in achieving this within anaesthesia. The issue of competence in technical interventions as a specific component of consent is highlighted by a tale from civil litigation which demonstrates adverse consequences for both patient and practitioner.

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Authors

Sophie Burns (Corresponding author)

FY2 doctor in General Practice
Townhead Surgery, Town Head
Settle, BD24 9JA
sophie.burns@doctors.org.uk

Dr MDD Bell MPhil FRCA FFICM

Consultant in Intensive Care/Anaesthesia
The General Infirmary at Leeds, LS13EX
Assistant Coroner - West Yorkshire (Western jurisdiction)
dominic.bell@nhs.net

References

1. Dalla-Vorgia P, Lascaratos J, Skiadas P et al. Is consent in medicine a concept only of modern times? J Med Ethics 2001; 27: 59-61
2. Mayberry M and J. Consent to investigation and treatment: the need for information. In: Consent in clinical practice.
3. Green DST, MacKenzie CR. Nuances of informed Consent: The Paradigm of Regional Anaesthesia. HSS J. 2007, 3(1): 115 – 118
4. Bolam v Friern Hospital Management Committee [1957] 1 WLR 582
5. Judgements – Chester (Respondent) v. Afshar (Appellant) House of Lords Session 2003 – 04 [2004] UKHL 41
6. Sokol DK. Update on the UK law on consent. BMJ 2015; 350:h1481
7. Medical Protection Society. New Judgment on patient consent. http://www.medicalprotection.org/uk/for-members/news/news/2015/03/20/new-judgment-on-patient-consent
8. Montgomery (Appellant) v Lanarkshire Health Board (Respondant) (Scotland) Hilary term [2015] UKSC 11, p 28
9. General Medical Council document. Consent: patients and doctors making decisions together. http://www.gmc-uk.org/static/documents/content/Consent_-_patients_and_doctors_making_decisions_together-english.pdf
10. Good Medical Practice
11. Reuber M, Dunkley LA, Turton EP. Stroke after internal jugular venous cannulation. Acta Neurol Scand. 2002; 105(3):225-9
12. Guidance on the use of ultrasound locating devices for placing central venous catheters. NICE technology appraisal guidance [TA49]. Published Sept 2002
13. The Royal College of Anaesthetists patient information publications http://www.rcoa.ac.uk/patients-and-relatives/patient-information-publications
14. AAGBI guidance http://www.aagbi.org/sites/default/files/consent06.pdf

Disclaimers

Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

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When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.