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the informed consent changes all the time and i think is really difficult and a few years ago we talked about the blm test and then there was the Blythe o test and now there are different tests I cant even remember the name for them and the way that things change and move along makes it really difficult give you an example Im no nice the dist we know that the chance of death following an anesthetic solely duty anesthetic its very almost too small to even calculate its a safe activity and I always tell patients youre safer having one of my anesthetics than you are driving home after youve had your operation particular if you drive yourself well get someone else to drive remember that but the problem with that is when youre talking with somebody about consent for an anaesthetic do you say well actually theres a chance of death what does that do to somebodys state of mind if theyre coming in for a relatively routine surgery which almost everybody is going to survive except ma