Consent for anaesthesia: guidelines from the Association of Anaesthetists.

Abstract

Guidelines on consent for anaesthesia were first issued by the Association of Anaesthetists in 1999 and last revised in 2017. These new guidelines respond to the changing ethical, legal and clinical landscape in which anaesthetists practice. Since 2017, the Montgomery judgment has changed medical consent practice. The General Medical Council standards on decision-making and consent and the National Institute for Health and Care Excellence guidance on shared decision-making also reinforce the need for high standards of patient advice and counselling. A Working Party, comprising representatives from professional societies, clinical and legal experts and public voice representatives, was established. Relevant new law and professional guidance was identified. A consensus process was not followed as the guidelines are based in law rather than academic opinion. The guidelines include a new section on peri-operative medicine and updated advice on the timing, mode, conduct and content of consent discussions. We emphasise the role of healthcare organisations in enabling good practice. We have aligned this guidance with contemporary advice from key organisations. These guidelines focus on the law in England and Wales, but we also highlight the key differences in law across the devolved nations of the UK and Republic of Ireland. Although UK law and professional guidance have influence in other English-speaking nations, a limitation of these guidelines is that they cannot be strictly applied outside the jurisdiction of the UK and Ireland. A second limitation is that they do not evaluate the resource implications that accompany them, such as clinical time and resources as well as costs of litigation and complaint.