There is considerable debate as to the extent of disclosure of risks when obtaining informed consent for anesthesia, especially when discussing with parents the rare risk of death of healthy children about to undergo elective, outpatient surgery. In Part I, we attempted to determine parents' knowledge about the risks of anesthesia as well as their thoughts toward either hearing, or not hearing, about the risk of death. In the first part of our study, 115 parents completed questionnaires before speaking with the anesthesiologist. Ninety-six (87%) wanted to know the chances of death as a result of anesthesia, whereas 14 (13%) did not. Seventy-five (68%) parents knew that this risk was “extremely rare,” 21 (19%) believed that it occurs “once in a while,” and 14 (13%) thought there was “no chance.” Eighty-two (74%) parents wanted to know “all possible risks,” 26 (24%) wanted to know only “those that are likely to occur,” and 3 (2%) wanted to know only about those that would “result in significant injury.” Mothers were more likely to want to hear all possible risks, whereas fathers were more likely to want to know only about those that are likely to occur (P = 0.001). Otherwise, responses were not influenced by the sex of the parents, the age of the child, or whether the child or any siblings had had surgery in the past. In Part II, a separate group of 121 parents were surveyed after participating in the preanesthetic discussion with the anesthesiologist. Of 74 parents in the group that had the risk of death either mentioned or implied, 65 (88%) wanted this information, whereas 8 (11%) did not, and one stated that it did not matter. In the group that did not have the risk of death either mentioned or implied, 18 of 47 (38%) parents revealed that they did not want this risk discussed, but 22 (47%) wished it had been included, and 7 (15%) stated it did not matter. Responses were not influenced by the sex of the parent, age of the child, or whether the child or any siblings had had surgery in the past. Several parents thought it was inappropriate to discuss the risk of death with children present. Our results indicate that most parents of healthy children presenting for outpatient procedures are already aware of the risk of death due to anesthesia and would like to discuss it further in the preanesthetic discussion.
(Anesth Analg 1993;77:256-60)
This material was presented in part at the annual meeting of the International Anesthesia Research Society, San Diego, California, March 19-23, 1993.
© 1993 International Anesthesia Research Society