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Anesthesiology/declining anesthesia care


I want to ask this odd question to an anesthetist; thanks for reading it.  I recently scheduled a colonoscopy and made sure that the endo center was o.k. with my declining sedation, anesthesia or anesthesia-related care (due to 2 previous terrible experiences) and they said that this would be no problem just be sure to reming the GI doc on the day of the procedure when you meet him.  Fine.  On the day of the procedure and anesthetist asks me to sign a sedation consent and when I try to explain that I'm not getting sedation or anesthesia she gets upset.  She tells me that anesthesia was scheduled for my case and that even if I refuse sedaion that I still have to sign the consent and that she will be present to "keep me safe".  I try to be polite and explain that it makes no sense to sign a consent for sedation that I'm refusing and that since I'm not getting anything she has no role in my case....She keeps badgering me to sign and walks out when I request to speak to the GI doc (who was busy); she returns and again insists that I sign the consent and that I have no choice but to accept her services.  At that point my wife suggests that we leave.....Is such behavior normal and is it true that I have to sign a consent or accept her "services" even though I'm not consenting to any anesthesia care?   Thanks.


Thank you for your questions.  I'll do my best to answer them.

In short, no.  You do not have to accept her services.  It is your right, as a patient, to decline the procedure and/or anesthesia service.  What it will depend on is the GI doc performing the procedure.  If they are comfortable with you being awake, and that you can tolerate the procedure, there should be no reason this route cannot be utilized.  

If the GI doc says they can try to do it without sedation, but if you cannot tolerate it, light sedation can be implemented.  This can be in the form of conscious sedation, where the RN would be the one administering certain medicines (usually midazolam and/or fentanyl)to obtain 'cooperation' from the patient so that the GI doc can perform/finish the procedure.  

If a deeper plane of sedation is needed, this would be where an anesthesia provider would step in (although some facilities utilize anesthesia providers for all types/levels of sedation outside of a general anesthetic).  

If the GI doc insists on anesthesia, then it might be time to consult a GI doc willing to accommodate your wishes.

And to add, in my experiences, that behavior is not common, is unprofessional, and if it actually occurred the way you have described it, a written complaint could always be considered.

Good luck with your decision.  If you have any further questions/clarifications, please do not hesitate to ask.

Thanks again-


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Dino Kattato MSNA CRNA


Former ICU/ER RN with several years of experience. I can answer questions relating to the CRNA education process, professional issues involved, as well as questions about adult and pediatric clinical anesthesia.


Level I regional Trauma center dealing with simple to complex patient populations of all ages. Experience with general anesthesia, spinal and epidural anesthesia, and total IV anesthesia for all surgical specialties including neuro, ortho, general surgery, vascular, electrophysiology, and VIR, with the exception of cardiac anesthesia. Ambulatory surgery center dealing mostly with ENT, plastics, and eyes (70%:30% peds:adults).


AANA Journal February 2010 Feb;78(1):24-7.


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