RESUMO
The changing ethical and legal landscape in the UK means that anaesthetists should routinely be discussing the risk of death during the consent process. To do this effectively means expanding anaesthetic preassessment services for children and young people, something that has been recognised as a priority, but which still needs investment and an appreciation of its value at the trust level.
Assuntos
Consentimento Livre e Esclarecido , Cuidados Pré-Operatórios , Humanos , Criança , Cuidados Pré-Operatórios/métodos , Adolescente , Reino Unido , Anestesia/éticaRESUMO
A surgeon, Dr A. Droit, has been following a 97-year-old male with a type IV thoracoabdominal aneurysm, which became symptomatic this morning and is leaking. The patient is frail but active with no important comorbidities. The anatomy demands an open procedure. The patient is a former renowned physician who has been a longtime family friend of Dr Droit-like a grandfather. He presented incoherent with sagging blood pressure. A complicating factor is that Dr D. Rag, the chief anesthesiologist, decided that neither he nor any of his staff would provide anesthesia. Dr Droit knows an anesthesiologist who handles high-risk patients at another hospital in the medical center. The patient has worsened over the last hour, is becoming more unstable, and is unable to respond but his wife wishes to consent for surgery. What should Dr Droit do?
Assuntos
Aneurisma da Aorta Torácica/cirurgia , Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Obrigações Morais , Seleção de Pacientes/ética , Papel do Médico , Procedimentos Cirúrgicos Vasculares/ética , Fatores Etários , Idoso de 80 Anos ou mais , Anestesia/efeitos adversos , Anestesia/ética , Serviço Hospitalar de Anestesia/ética , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/fisiopatologia , Acessibilidade aos Serviços de Saúde/ética , Hemodinâmica , Humanos , Consentimento Livre e Esclarecido/ética , Masculino , Transferência de Pacientes/ética , Recusa em Tratar/ética , Medição de Risco , Fatores de Risco , Cônjuges , Procedimentos Cirúrgicos Vasculares/efeitos adversosAssuntos
Anestesia/ética , Anestésicos/administração & dosagem , Anestésicos/provisão & distribuição , Pena de Morte , Experimentação Humana não Terapêutica , Dor/etiologia , Prisioneiros/legislação & jurisprudência , Estresse Psicológico/etiologia , Populações Vulneráveis/legislação & jurisprudência , American Medical Association , Anestesia/métodos , Anestesia/normas , Pena de Morte/legislação & jurisprudência , Pena de Morte/métodos , Pena de Morte/tendências , Códigos de Ética , Comércio/legislação & jurisprudência , Indústria Farmacêutica/ética , Indústria Farmacêutica/tendências , Ética Médica , União Europeia , Humanos , Experimentação Humana não Terapêutica/ética , Experimentação Humana não Terapêutica/legislação & jurisprudência , Tiopental/administração & dosagem , Tiopental/provisão & distribuição , Estados UnidosRESUMO
Levels of public and private funding for anesthesia services and health research reflect their value to the patient, the payor, and society. Improvements in anesthesia depend heavily on technologic advances. This article presents practical realistic assessment of medical innovation and barriers to its commercialization. Innovation by either academia or industry working in isolation is not possible. Innovation, education, and commercialization are interdependent and contribute to medical progress only when applied as a whole. Subordinating productive relationships between anesthesiologists and industry representatives to concerns of conflict of interest potentially puts diminishes the value of medical services, including anesthesia.