Volume 4, No. 3 • Fall 1989

‘Abandoning’ PACU Patients to Do Next Case

Peter R. Fletcher, M.A., B.M. B.Ch. (Oxon), M.R.C.P. (U.K.)

To the Editor

I have been following the correspondence on “briefly leaving the patient” with increasing dismay. It seems to me that your correspondents have totally missed an important point.

In general, a physician may not legally (let alone ethically) relinquish responsibility for a patient with whom he has established a patient-physician relationship unless the patient either no longer needs care or has been transferred to the care of another physician.

Although there are some legally created exceptions to this general rule, none of these are relevant to the anesthesiologist-patient relationship. An anesthesiologist who commences the “solo” administration of anesthesia to a patient for an elective case leaving other patients for whom he has accepted responsibility in the Recovery Room without the immediate availability of another appropriately skilled and qualified individual to render needed emergency care is, in my mind, already guilty of abandoning those patients. The question raised, therefore presupposes a situation in which he had already (in my view) seriously transgressed against the ethics of our profession due to the lack of PACU coverage. His dilemma is artificial because it arises out of his choice to place himself in that situation.

Peter R. Fletcher, M.A., B.M. B.Ch. (Oxon), M.R.C.P. (U.K.), Drexel Hill, PA.