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Young people have additional needs and may wish to speak to the anaesthetist or another member of staff without direct parental presence.^66,99 Anaesthetists should make it clear that they are willing to speak with young people on their own, on request.

Post menarcheal women should be made aware of the need for clinicians to establish pregnancy status before surgery or procedures involving anaesthesia. While obtaining and documenting this information is primarily the responsibility of the operating surgeon or paediatrician, anaesthetists may also feel it necessary to confirm that such checks have been performed. Trusts should have agreed policies and arrangements for...

Anaesthetists treating children and young people must ensure that they understand the requirements for consent in the part of the UK in which they are working.^55,57,58,59

Parental responsibility should be established in advance of admission, and appropriate consent procedures followed, involving the court and/or social services as appropriate.

For planned procedures, if there is doubt about parental responsibility, advice should be sought from senior hospital medicolegal advisers and/or defence organisations.

Although separate written consent for anaesthesia is not mandatory in the UK, there should be a written record of all discussions with the child and/or parent/carers about methods of induction, and provision of postoperative pain relief (including the use of suppositories).102,103

Where special techniques such as neuraxial blockade and regional blocks, invasive monitoring and blood transfusions are anticipated, there should normally be written evidence that this has been discussed with the child or young person and/or their parents or carers as appropriate.^102,103

Children may require anaesthesia for diagnostic procedures, such as magnetic response imaging.

The consent process is essentially composed of two components: consent for the procedure and consent for the general anaesthesia or sedation.

The referring clinician (or radiologist in some institutions) is responsible for the explanation of risks vs benefits, including the possible risks of the imaging is not carried...

If withdrawing or withholding life-sustaining treatments is being considered, possible outcomes and plans should be carefully discussed and documented by the MDT team of professionals and the family/young person (as appropriate), in advance of planned anaesthesia and including the management of ‘do not attempt cardiopulmonary resuscitation’ orders.^106,107,108

Duty of candour guidelines must be followed.¹⁰⁹