University of the Pacific colleagues Drs. Dower, Indresano, Peltier and Jacobsen have posed further interesting thoughts secondary to the concept of informed consent for anesthesia.
Dr. Jacobsen is correct when he states that I am an attorney. I have also completed residencies in anesthesiology (MS) and oral and maxillofacial surgery, but, first and foremost, I am a dentist. Interestingly, a colleague and I completed the exploration and repair of a lingual nerve recently. The patient’s history included the statement that she felt lightning shoot through her tongue during the administration of the local anesthesia, and she has had a numb tongue since.
As was mentioned in March JADA letters,1 the standard of care ultimately is developed by lay juries, after they have heard contrasting opinions during the battle of experts in trial. Right or wrong, what we as health professionals say about the standard of care is only preliminary, relative to subsequent legal analysis.
As our informal study showed, it appears that a significant number of dentists already provide consent for anesthesia. The addition of "anesthesia" to one’s current written list of etiologies for potential complications, ranging from bruising to death, would not appear to be overly burdensome or time-consuming.
Drs. Dower, Indresano and Peltier iterate important points regarding 4 percent solutions. These men are not isolated academics speaking in theoretical terms about new matters, as evidenced by more and more clinical publications reiterating these historically well-documented concerns.2,3
The comments from our University of the Pacific colleagues are very much appreciated.
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