"Guidelines on informed consent in anaesthesia: unrealistic, unethical, untenable…."

Fially, an editorial in the BJA expressing what nearly all anesthesiologists know deep in their hearts, and for that matter all physicians .... truly informed and understanding informed consent is a utopian dream for many patients (read editorial here). Moreover, it is a dream that can be complicated by unrealistic legal requirements. This latter is also expressed in the final conclusion of this editorial.

In clinical practice, the physician's primary responsibility must come down to acting and interacting in the best interests of the individual patient in front of them. The inevitable failure to meet unrealistic expectations of recent legal rulings on informed consent will probably continue to impair communication with patients and cause inadvertent patient harms. It is becoming increasingly clear that the disconnect between legal expectations and the reality of communicating with patients in difficult and highly stressful situations is having the opposite effect to what is intended. Is it not time to change the paradigm of informed consent from legal-centred to patient-centred anaesthesia care?

This fine editorial makes us once again, all realize the difficulties inherent in providing good patient care.

G.M. Woerlee is an anesthesiologist with more than 30 years of clinical anesthesia experience, a longstanding interest in perioperative management, as well as author of several books such as “Gerry’s Real World Guide to Pharmacokinetics & Other Things”, and “Common Perioperative Problems & the Anaesthetist”. He is now founder and CEO of Woerlee Praktijk BV, a company producing a self-learning decision-support, quality control, benchmarking, and audit software suite for anesthesiologists and surgeons called PANSURAS (Perioperative ANesthesia & SURgical Assessment System), a system providing seamless integration and monitoring of a Perioperative Surgical Home.