Being self-aware sometimes to the point of turning self-critical — I, as a constituent of an anesthesiologist’s society, am writing this freestanding letter to bring forth our ethical questions and concerns regarding a shortage of not only medications but also skills, funds and time.
Scenario 1: Patient requests for spinal anesthesia for cesarean section, but a shortage of hyperbaric spinal anesthetics warrants epidural anesthesia as its replacement. What must be done? Is it sufficient to inform the patient, consent the patient for epidural anesthesia and move on?
Scenario 2: Patient requests for ultrasound-guided transversus abdominis plane block but a shortage of traditional team’s skill in regards to the “new kid on the block” discourages its use in the patient. What must be done? Is it sufficient to acknowledge team’s deficiency, give the option to choose an alternative method or an alternative team, and move on?
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