Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
The potential for performing unjustified surgical procedures is a blindspot within the WHO Surgical Safety Checklist. When used well, the WHO Checklist creates a comprehensive and robust framework of safety around the patient whilst in theatre. It ensures that the surgical procedure to be performed is agreed by the patient and the surgeon. It does not however protect against carrying out surgery that may be ill-advised or even inappropriate. As part of the WHO Checklist we already routinely ask the patient to tell us, in their own words and in the presence of the surgeon, what they understand the intended procedure to be. Perhaps we should also use the opportunity to ask them what they expect to achieve from having the procedure; and then ask the surgeon to confirm that this is a reasonable (or at least not unreasonable) expectation, and that the procedure would be widely regarded as a standard technique supported by evidence. Perhaps also the current evidence base for procedures could be maintained and readily available to patients and staff (particularly other members of the theatre team). This would certainly enhance staff (and student) education and may well strengthen the consenting process.
Making these additions to the WHO Checklist would better allow theatre teams to be confident that that they are providing care which is not only safe, but also in the patient's best interests.
Competing interests:
No competing interests
10 May 2017
Sarah C Hagyard
CT1 anaesthesia
Mark W Davies, consultant in anaesthesia & perioperative medicine
Royal Liverpool & Broadgreen University Hospitals NHS Trust
Re: Breast surgeon is convicted of 20 counts of unlawful wounding and wounding with intent
The potential for performing unjustified surgical procedures is a blindspot within the WHO Surgical Safety Checklist. When used well, the WHO Checklist creates a comprehensive and robust framework of safety around the patient whilst in theatre. It ensures that the surgical procedure to be performed is agreed by the patient and the surgeon. It does not however protect against carrying out surgery that may be ill-advised or even inappropriate. As part of the WHO Checklist we already routinely ask the patient to tell us, in their own words and in the presence of the surgeon, what they understand the intended procedure to be. Perhaps we should also use the opportunity to ask them what they expect to achieve from having the procedure; and then ask the surgeon to confirm that this is a reasonable (or at least not unreasonable) expectation, and that the procedure would be widely regarded as a standard technique supported by evidence. Perhaps also the current evidence base for procedures could be maintained and readily available to patients and staff (particularly other members of the theatre team). This would certainly enhance staff (and student) education and may well strengthen the consenting process.
Making these additions to the WHO Checklist would better allow theatre teams to be confident that that they are providing care which is not only safe, but also in the patient's best interests.
Competing interests: No competing interests