Surgeons should tell patients how much sleep they have had before carrying out procedures, it has been suggested.
Writing in an editorial in the New England Journal of Medicine, Dr Michael Nurok and colleagues from the Hospital for Special Surgery, New York, USA, state that sleep-deprived doctors should not be permitted to complete planned surgery without the patient’s informed, written consent.
They write: "This approach would represent a fundamental shift in the responsibility patients are asked to assume in making decisions about their own care and might prove burdensome to patients and physicians and damaging to the patient-physician relationship."
But it "may be necessary until institutions take the responsibility for ensuring that patients rarely face such dilemmas", they believe.
The authors call for regulations to restrict doctors’ working hours, as research shows that sleep deprivation severely impairs psychomotor performance.
They draw attention to a 2009 study in the Journal of the American Medical Association, which found a significant rise in the risk of complications following daytime surgery by surgeons who had less than a six-hour opportunity for sleep during a previous on-call night.
They add that surveys suggest most patients would ask for a different doctor if they knew that their surgeon was sleep deprived.
Dr Nurok says: "We think that institutions have a responsibility to minimise the chances that patients are going to be cared for by sleep-deprived clinicians. A lot of institutions are not going to be able to take that leap immediately, so as an interim step, we believe that patients need to be informed."
Nurok, M. et al. the New England Journal of Medicine (in press).
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