What are we Telling Our Patients? A Survey of Risk Disclosure for Anaesthesia in Australia and New Zealand

Abstract

The aim of our study was to determine the range of risks disclosed in four commonly-encountered clinical scenarios: knee arthroscopy, lumbar laminectomy, laparoscopic appendicectomy and laparotomy, and then to determine how often five commonly-disclosed risks were disclosed for each scenario. We conducted a pilot survey of consultant anaesthetists in the Auckland City Hospital, the Royal Melbourne Hospital and the Austin Hospital (response rate 59%). A web survey was then sent to 500 randomly-selected Australian and New Zealand College of Anaesthetists Fellows (response rate 29%). In the pilot survey, a wide range of risks were disclosed: five (range 0 to 13) for knee arthroscopy, seven (0 to 16) for lumbar laminectomy, six (0 to 13) for appendicectomy and nine (0 to 24) for laparotomy. In the web survey, the disclosure rates for all risks varied widely from “rarely” to “always”. Respondents were more likely to disclose risks infrequently if they were male (odds ratio 5.7, P=0.002) or exclusively in private practice (odds ratio 4.1, P=0.02). Age >45 years was not associated with disclosure frequency (odds ratio 1.65, P=0.23). While the low response rate limits the validity and generalisability of many of our findings, we can nevertheless confidently conclude that risk disclosure varies widely in Australia and New Zealand. This large variation should be of concern to all anaesthetists. More work is needed to understand the reasons for this variation, and to develop a stronger consensus among anaesthetists about what risks should be disclosed.