Standards for Monitoring During Anesthesia at Harvard

To the Editor.—  The article entitled "Standards for Patient Monitoring During Anesthesia at Harvard Medical School"¹ does a disservice to the practicing anesthesiologist and a service to the legal profession.For example, the article states that "monitoring end-tidal carbon dioxide is an emerging standard and is strongly preferred." In almost 30 years of anesthesia practice, I have yet to encounter a case in which the outcome could have been changed by the presence of such a monitor. Does this mean that every anesthesia department in the country will have to use hard-to-come-by dollars to buy such monitors? And how eager will malpractice lawyers be to confront the anesthesiologist—when a fatal outcome can possibly be traced to anesthesia—with the statement that the anesthesiologist was at fault for not using a carbon dioxide monitor?This article has given the legal profession an easy checklist to use when encountering any malpractice case