What should I tell my patient? Disclosure in anaesthesiology: difficulties, requirements, guidelines and suggestions

Abstract

South African anaesthesiologists have embraced the requirement for authentic informed consent, but there is no consensus regarding the comprehensiveness and specificity requirements with regard to the information that needs to be supplied to the patient, and upon which decisions will be based. Anaesthesiology is an unusual specialty. The scope of knowledge and expertise that practitioners require is wide-ranging, from the basic and applied biomedical sciences and technology, clinical knowledge and experience, through to hands-on operating room experience and expertise, feeding into the requirement to inform. Contemporary practice environments limit contact time with patients. Societal ethos demands recognition of basic human rights, amongst others the right to personal autonomy. The South African Health Professions Council has published a series of booklets describing guidelines to ethical medical practice, one of which is on informed consent. This article discusses the information requirements for valid informed consent from both a moral and regulatory perspective. The practical implications for anaesthesiologists of the HPCSA guidelines on informed consent are discussed, a model interview is proposed, and a number of illustrative cases are discussed. The aim is to answer the question: What should I as anaesthesiologist tell my patient?