Surgeons, Sleep, and Elective Surgery.

[tiedyeddog]

This is a very open ended question, focused on an article recently published in the NEJM. Here is a summary of it and more debate on the issue: http://www.interndaily.com/reports/...ed_To_Disclose_Sleep_Deprived_Status_999.html

Should surgeons be forced to disclose to patients about to undergo elective surgery how many hours of sleep they have had the previous night or that they were up on call the entire night previous to the elective surgery? Should they then give those patients the choice to reschedule, discontinue the surgery, or find a new surgeon?

Furthermore, is it ethical in the first place to operate on patients seeking elective surgeries after being awake for over 24+ hours straight?

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[45408]

Furthermore, is it ethical in the first place to operate on patients seeking elective surgeries after being awake for over 24+ hours straight?

Sure. It's unethical to lie about how long you've been awake, but if you can do a procedure safely (I'm aware of the increased complication rates cited in the article), then there's nothing unethical about it.

Patients may have made logistical provisions for their surgery and may be unhappy if they have to reorganize their schedule again. Clinicians may lose cases to colleagues and thus income. Departments and institutions may lose income if patients reschedule and seek treatment elsewhere.

And while the study authors acknowledge that there may be financial and administrative costs associated with any informed consent plan, they argue that the costs may be offset by improved surgical outcomes and reduced complications.

"May have made logistical provisions"? Who hasn't? Most people have to take at least several days or a week off work for even fairly minor procedures, and if you're in a line of work that involves moderate/heavy lifting, you're going to be off for weeks after a hernia repair. Telling your boss "I'll be gone next month," and then reneging on that because your surgeon was tired is actually a huge deal for most people.

And I find it extremely unlikely that significant cost savings would actually be realized with implementing this step.