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Medicine Science

Do Sleepy Surgeons Have a Right To Operate? 332

Hugh Pickens writes "BusinessWeek reports that a commentary from the New England Journal of Medicine calls on doctors to disclose when they're deprived of sleep and not perform surgery unless a patient gives written consent after being informed of their surgeon's status. 'We think that institutions have a responsibility to minimize the chances that patients are going to be cared for by sleep-deprived clinicians,' writes Dr. Michael Nurok, an anesthesiologist and intensive care physician. Research suggests that sleep deprivation impairs a person's psychomotor skills — those that require coordination and precision — as much as alcohol consumption and increases the risk of complications in patients whose surgeons failed to get much shuteye."
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Do Sleepy Surgeons Have a Right To Operate?

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  • by santax ( 1541065 ) on Saturday January 01, 2011 @09:24AM (#34729628)
    Come on, so you get into the ER, need treatment right away, you're gonna tell the only doc available to first get some sleep? Don't think so. The hospital/doc should have made sure that the staff is fit enough to even be on watch. This will just mean: yes sir we are very sorry you lost your kid due to bad handling from are doctor, but look here: that is your signature. So you can kiss that lawsuit goodbye. Hospitals shouldn't have people who are sleepdrunk on the watch. Simple as that.
  • by Anonymous Coward on Saturday January 01, 2011 @09:25AM (#34729632)

    Silly question. Surgeons never have a right to operate on people, any more than anyone else has a right to cut people open and poke around inside. Surgery must always be based on consent, now that can be complicated by circumstancses - an unconscious patient can't say yes or no and depending on the circumstances in which they were found and the consequences of waiting then reasonable assumption may have to be made as to what they would want. However, ensuring as far as possibel that they are able to give informed consent is the right thing to do, and that does mean providing information like "the surgeon's drunk" or "the surgeon is sleep deprived". Putting it in terms of a "right" to perform surgery is absurd.

  • Trust a doctor (Score:5, Insightful)

    by pehrs ( 690959 ) on Saturday January 01, 2011 @09:35AM (#34729674)

    Asking me to sign a waiver should a surgeon about to cut me open be tired seems only like a CYA policy. I can't make an informed decision, and I am most likely in distress and need of the surgery and saying no would delay it.

    I am already putting a huge amount of trust in his abilities, and that includes him being able to decide if he skilled and in shape to do the operation or not. If I can't trust my doctor to make that decision I can't trust him to operate at me anyway. Therefor this seems completely pointless.


  • by Anonymous Coward on Saturday January 01, 2011 @09:38AM (#34729678)
    Killed five people while she was at it. Good for her! Now she has a shitty BMW to show for it!
  • this is just dumb (Score:5, Insightful)

    by Triv ( 181010 ) on Saturday January 01, 2011 @09:40AM (#34729684) Journal
    Your relationship with your doctor is based on trust and consent - you don't ask your taxi driver to submit to a breathalyzer before he drives you home, so why should you ask your doctor how he's sleeping? If you don't trust your doctor to be operating on you in good condition, you need to find yourself a different doctor.
  • article's title (Score:3, Insightful)

    by underqualified ( 1318035 ) on Saturday January 01, 2011 @09:44AM (#34729714)

    "Doctors Urged to Admit Fatigue Before Performing Surgery"

    I wish we had something similar in my previous company.

    "Developers Urged to Admit Fatigue Before Fixing Bugs"

  • Re:Proper rest (Score:4, Insightful)

    by dkleinsc ( 563838 ) on Saturday January 01, 2011 @11:25AM (#34730172) Homepage

    3 cheers for checklists! My sister is studying nursing right now. Those checklists are life-savers.

    I also have friends who are or recently have been medical residents. That kind of pressure, with shifts that last well over 12 hours, is quite simply an abusive labor practice.

  • by TapeCutter ( 624760 ) on Saturday January 01, 2011 @11:42AM (#34730242) Journal
    "Fortunately, the stay was covered, which was lucky because my insurance company only covers one of the local hospitals for things which aren't trauma care or preapproval."

    As an Aussie who enjoys cheap and effective universal health care, I cannot for the life of me understand why Americans are not outraged by that sort of bullshit.
  • Re:Proper rest (Score:5, Insightful)

    by bill_mcgonigle ( 4333 ) * on Saturday January 01, 2011 @11:52AM (#34730272) Homepage Journal

    The military has a culture that's designed to take ego out of the decision processes. Perhaps imperfect, but the danger is recognized and dealt with. Now, try working at a hospital...

    Actually, it would be interesting to compare military hospitals with civilian and see how they rate on important measures.

  • by Phoobarnvaz ( 1030274 ) on Saturday January 01, 2011 @01:48PM (#34730976)

    Pilots, truck drivers, and nuclear reactor operators have work hour controls to ensure that fatigue is managed. The same should be true with doctors.

    This has been tried...but you have prick's who believe this is the only way to teach medicine who made sure things stay the matter the result.

    Having worked with doctors on a daily basis in the past...unless I am losing a limb...a big amount of blood or something major...I only want nurses to working on me. More times than not...they're the ones with the good bedside manner without being a prick. Plus...they are usually not sleep deprived.

  • Re:Develop a test (Score:4, Insightful)

    by Shotgun ( 30919 ) on Saturday January 01, 2011 @04:30PM (#34732148)

    You would think it would be a big win for everybody. You would be wrong.

    It's a BIG loser for the dispatchers and salesmen. When I hired on for RTC, they gave us an indepth class on how to get more driving hours in a day. It involved sleeping and driving in four hour shifts. Now, WHY would they do this?

    Because, clients would gravitate to the company that could deliver on time. There were penalties, up to and including simply refusing to accept the load, for not delivering on time. Salesmen would indiscriminately put tickets for hauls in. No consideration was taken for capacity. Dispatchers were responsible for seeing that the loads got hauled. Dispatchers could say something along the lines of, "Yeah. That's not possible. Trucks don't move that fast." Dispatchers who said something along those lines would end up asking, "You want fries with that?"

    The bottom man on the pole was the driver. He got handed a ticket that said he had to haul a load 1000 miles by noon tomorrow. He could say something along the lines of "Yeah. Given our current space-time continuum and the laws of the Interstate Highway System, that is not physically possible." The next thing he would say is, "You want fries with that?"

    The impairment testing would document that a driver was unfit to drive, something most drivers know already. After an accident, the first thing the insurance company would ask for is to see the results of the impairment test, and then deny the claim because the driver had been turned around with a forged log book after a 1500 mile marathon run.

    Impairment testing is a win for everyone, except for the people that would be responsible for installing them.

  • Re:Develop a test (Score:5, Insightful)

    by leromarinvit ( 1462031 ) on Saturday January 01, 2011 @08:35PM (#34733850)

    Impairment testing is a win for everyone, except for the people that would be responsible for installing them.

    Sounds like a good candidate for a law then, doesn't it?

Our business in life is not to succeed but to continue to fail in high spirits. -- Robert Louis Stevenson