A doctor writes
Sir: I am a retired surgeon. John Studd's letter (26 August) reminds me of a dilem- ma that faces the operator occasionally, one with which your readers may not be familiar. You are operating on a patient who, for any of a variety of reasons, has been declared a poor anaesthetic risk. You find a condition which definitely requires attention, which is beyond the scope of the patient's consent given pre-operatively. Do you go ahead, or close up and allow the patient to recover with a view to a further anaesthetic and operation after the situa- tion has been explained and consent given? In the latter event, it is most likely that a further anaesthetic will be refused or delayed, again for a variety of good reasons. It is hardly in the patient's interest to freeze the situation while you phone relatives and the medical defence office for advice!
P.J.W. Rowell
3 Poplar Street, Southport, Lancashire
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