An Occupant You Don't Want Asleep on the Job

Sleep-deprived surgeons should get consent from patients before performing elective surgery, says editorial

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Since sleep deprivation impairs psychomotor performance to the extent that alcohol-intoxication does, an editorial in this week's New England Journal of Medicine argues sleep-deprived physicians should not be allowed to perform elective surgery without written consent from the patient.

This approach would shift the responsibility patients are asked to take on in a fundamental way, according to the editorial's authors. This shift is a necessity in their view "until institutions take the responsibility for ensuring that patients rarely face such dilemmas."

Complicating matters is the fact that sleep-deprived individuals often fail to accurately assess the extent of their impairment.

According to Michael Nurok, M.D., Ph.D., an anesthesiologist and intensive care physician at Hospital for Special Surgery and first author of the editorial, sleep-deprivation in surgeons increases risks of complications and affects clinical performance. He said survey data makes it clear patients would request a different provider from a physician who was sleep deprived.

Regulations restrict the work hours of doctors in training, but these regulations don't exist for trained physicians. Some hospitals take measures to ensure surgeons are not in a sleep-deprived state, but not enough is done to protect patients, according to the editorial. Elective surgery, they argue, can be rescheduled since there is no urgency involved, making it a "nice place to start to think about policy approaches."

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Review Date: 
December 31, 2010
Last Updated:
January 3, 2011