A new British report shows that surgeons are performing too many “inappropriate and aggressive” operations on patients who are frail or terminally ill.

The perioperative death rate in the UK now stands at 10 per cent too high according to the recently released The National Confidential Enquiry into Perioperative Deaths 1996/ 1997, the periodic survey which examines data on patients who die within 30 days of a surgical procedure. This time, the enquiry examined 2,541 deaths (or 13 per cent of the 19,496 perioperative deaths which occurred during the year April 1996 to March 1997) in detail.

It counselled surgeons that it is a “surgical skill” to recognise when surgery is “too adventurous, ill advised, or futile”, given the patient’s condition. It urges that surgeons be very clear about the aims of surgery noting that, “a decision to operate may not be in the best interest of the patient.”

A copy of the full report can be obtained from

NCEPOD, 35-43 Lincoln’s Inn Fields, London, WC1A 3PN, £15 (BMJ, 1998; 317: 1269).

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Written by What Doctors Don't Tell You

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