The Ethical Issues with Anesthesiological Informed Consent and How it can be Improved
Ryosuke Morikawa
Volume 1 Issue 1 Pages 83-88
First Published: September 28, 2018
[Japanese]
Abstract
Anesthesia is necessary for surgical operations, but it can cause anxiety and risks for patients. Anesthesiologists should always obtain informed consent before administering anesthesia. However, it is doubtful that, in general, autonomic patients themselves would make a decision to receive anesthesia. Ideally, informed consent should contribute to better doctor-patient relationships, and patients themselves should decide their treatment plans following the consent procedures. However, in a clinical setting, anesthesiological informed consent is often performed at bedside, in a short amount of time, and by someone other than the responsible anesthesiologist. This situation may be due to the nature of anesthesiologyin almost all cases, anesthesia is requested by each surgery department and anesthesiologists tend to be fully occupied with intra-postoperative management. Also, patients generally think they do not have control over anesthesia and tend to leave it entirely up to the anesthesiologist. To improve this situation, many measures have been taken, including performing preoperative assessment at preoperative anesthesia clinics (PACs), introducing anesthesia nurse coordinators and using audiovisual aids in preoperative evaluations. Comparing the informed consent practices with other countries, such as the United States and Germany, also serves as a good reference. While these measures may improve anesthesiological informed consent, it is important that anesthesiologists do their best to communicate with patients. To build a good doctor-patient relationship, each anesthesiologist should reexamine the importance of informed consent and continue to brush up on his/her informed consent skills.
