Healthcare News & Insights

Your surgeon was up all night — does informed consent require you know that?

An article in The New England Journal of Medicine raises an ethical question: How much information — and how often — must a patient be given to ensure they’ve given truly informed consent?

Take the example that leads off the article: A surgeon on an overnight call ends up spending most of the night prepping and performing a complicated emergency surgery. As a result, he or she gets little sleep, even though the surgeon has one or more elective surgeries scheduled to begin early the next morning.

Does informed consent require the doctor let patients know that their surgeon pulled an all-nighter and may not be prepared to do his or her best work? Should hospitals even allow doctors to schedule themselves this way in the first place?

There are powerful arguments on either side. Surely, in an ideal world, doctors would be fully rested before performing any procedure. But in reality, providing continuous care in an understaffed, often under-resourced health care system means flexible scheduling is more of a pipe dream than a possibility.

Nor would patients likely respond favorably to having a doctor call in “tired” after they’ve arranged time off from work and someone to drive them home, as well as mentally and physically prepared themselves for the procedure.

On the other hand, not many of us about to be put under general anesthesia, would be comforted to hear a doctor mention that he or she only got two hours of sleep the night before — whether the reason was job-related or not.

How far should informed consent go? Share your thoughts in the comments.

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