A New Concept for Obtaining Informed Consent on Anesthetic Risk

Abstract

  Medicine is one of mandate or contract for work. It is the reason why a duty to disclose a patient's information has been occurred by medical doctor as follows ; First, it is necessary to obtain a patient's consent for justification for illegality with physical invasion. Second, a human being has the right to decide for his life by himself. Third, it is necessary to inform as concerns the judgement of leading him to adequate treatment including to transport a patient to another doctor. Fourth, if the patient is harmed in some way, it is important to explain the cause. If the doctor explains medical information to a patient, he should explain as clearly as possible on the basis of patients' appreciation, cognition, judgement, age, and mental state. According to patient cognition, the doctor should explain his information using schema and/or photography. It is useful that the doctor delivers simple guidance on medical practice to the patient. The conditions of valid explanation are as follows ; First, the doctor who explains the state of affairs to the patient understands his clinical situation very well. Second, he has a lot of knowledge and abilities about clinical practice to explain to the patient cleary. Third, there is enough time for the doctor to explain to his patient. Fourth, the patient has sufficient ability to understand his medical situation. Fifth, the patient's mental state is stable. In my institute, an anesthesiologist supervisor examines every patient as pre-rounds of anesthesia in an exclusive consulting room befor surgical procedure. At the same time, the anesthesiologist obtains written informed consent from the patient, concerning anesthetic method, clinical procedure (for example ; tracheal intubation, intravenous infusion and epidural catheterization) , risk of anesthesia on the basis of statistical data, possible adverse effects and rare serious complications. In conclusion, today's medical relationship between doctor and patient tends to be considered an unfriendly obligation and /or opposed to each other. We must recognize that all medicine consists of a confidential relationship between doctor and patient, and this is required to treat the patient for his disease.