Informed consent for anesthesia in ambulatory surgery: A South African perspective

The nature and practice of anesthesiology problematises informed consent, particularly in the ambulatory setting. Timing and time-constraints counter an interactive free flow of information; access to understandable, contextual information forms the basis of free choice by empowering the patient to engage in an interactive conversation with the anesthesiologist, and broadens the base for further discussions and questions. Separate informed consent in anesthesiology is philosophically mandated by the requirement of rationality in choice and respect for personal autonomy, and legally to prevent litigation. The paradigmatic cascade model of consent entails determining competence, supplying information and promoting free choice. Particular measures to counteract the difficulties of anesthesiological informed consent in ambulatory surgery include measures to increase anesthesiologist-patient contact time, and wider use of pre-op clinics. Pre-printed forms are useful but do not replace an interview, tapered to the needs and requirements of the particular patient. Appropriate illustrative material and aids are advised.