Anesthesia: Standards of Care and Liability

To the Editor.—  In the article entitled "Standard of Care and Anesthesia Liability," Cheney et al¹ have clearly depicted recent medical liability problems in anesthesiology. Interest in patient safety and the prevention of mishaps in anesthesia, however, goes back nearly 150 years to the thorough investigation in England of the first recorded anesthetic death, some year and a half after the public demonstration in Boston, Mass, of general anesthesia.² Since that time, there have been many studies of anesthesia morbidity and mortality, including the important one of Beecher and Todd in 1955, which for the first time contained a denominator in the mortality rate, one anesthetic death per 1560 patients receiving anesthetics.²During the last two decades, it was generally estimated that anesthesia mortality ran between 1 and 5 deaths per 10 000 anesthetics given.² Most recently, however, there is evidence that the current anesthetic death