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.