Anaes · Ethics, consent & medicolegal

Ethics, consent & medicolegal

Also known as Medical ethics · Informed consent · Capacity assessment · Mental Capacity Act 2005 · Jehovah's Witness · Gillick competence · Duty of candour · Medical negligence — Bolam and Bolitho · Montgomery ruling

The ethics, consent and medicolegal framework governs the doctor–patient relationship in anaesthetic practice. The anaesthetist renders the patient unconscious and vulnerable, administers potent drugs, and makes life-and-death decisions, and so operates at the ethical and legal frontline. The framework rests on the four ethical principles of Beauchamp and Childress (autonomy, beneficence, non-maleficence, justice); the elements of informed consent (capacity, disclosure, understanding, voluntariness, consent) as reshaped by the Montgomery v Lanarkshire 2015 ruling on material risk; the specific anaesthetic consent (dental damage, aspiration, awareness, PONV, nerve injury, death; the ASA Physical Status Classification; the consent form); the assessment of capacity under the Mental Capacity Act 2005 (the two-stage diagnostic and functional test, and best-interests decision-making); the competent adult's absolute right to refuse treatment, including the Jehovah's Witness and blood products; children and consent (Gillick competence, Fraser guidelines, parental responsibility); restraint and the anaesthetist; confidentiality (the Caldicott principles, data protection, the duty of candour); and the medicolegal framework of negligence (duty of care, breach, causation, harm) under the Bolam 1957 test and the Bolitho 1997 refinement, with the role of the expert witness, the coroner and anaesthetic deaths, critical-incident reporting, and professional regulation (GMC, ANZCA, MBA, AHPRA). The conflicted Jehovah's Witness child is the exam-classic synthesis scenario.