PARENTAL KNOWLEDGE AND ATTITUDES TOWARD DISCUSSING THE RISK OF DEATH FROM ANESTHESIA

There is considerable debate as to the extent of disclosure of risks w hen obtaining informed consent for anesthesia, especially when discuss ing with parents the rare risk of death of healthy children about to u ndergo elective, outpatient surgery. In Part I, we attempted to determ ine parents' knowledge about the risks of anesthesia as well as their thoughts toward either hearing, or not hearing, about the risk of deat h. In the first part of our study, 115 parents completed questionnaire s before speaking with the anesthesiologist. Ninety-six (87%) wanted t o know the chances of death as a result of anesthesia, whereas 14 (13% ) did not. Seventy-five (68%) parents knew that this risk was ''extrem ely rare,'' 21 (19%) believed that it occurs ''once in a while,'' and 14 (13%) thought there was ''no chance.'' Eighty-two (74%) parents wan ted to know ''all possible risks,'' 26 (24%) wanted to know only ''tho se that are likely to occur,'' and 3 (2%) wanted to know only about th ose that would ''result in significant injury.'' Mothers were more lik ely to want to hear all possible risks, whereas fathers were more like ly to want to know only about those that are likely to occur (P = 0.00 1). 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 s urgery in the past. In Part IL a separate group of 121 parents were su rveyed after participating in the preanesthetic discussion with the an esthesiologist. 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 n ot 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 th e risk of death with children present. Our results indicate that most parents of healthy children presenting for outpatient procedures are a lready aware of the risk of death due to anesthesia and would like to discuss it further in the preanesthetic discussion.