Deaths on the table: proposal for an international convention on the investigation and prevention of anaesthetic mortality.

National and international variations in clinical practice, study methodologies, and data collection make the estimation of patient deaths attributable in some measure to anaesthesia a difficult task. Such rates have undoubtedly significantly declined, a tribute, in large part, to the work of groups such as the International Committee for the Prevention of Anaesthetic Mortality and Morbidity, the Anesthesia Patient Safety Foundation and the Australian Patient Safety Foundation. There is, however, internationally, still a significant risk of mortality associated with anaesthesia which is distinct from that related to any relevant surgery or intercurrent disease. As a matter of pure logic, patients worldwide should be entitled to expect a basic minimum of knowledge and skills from an anaesthetist, as well as his or her use of standard monitoring equipment. In an age where the global provision of health services and equipment may be increasingly dominated, under trade-promoting international agreements, by a few trans-national corporations, and where technology facilitates dissemination of medical data, a unified, worldwide approach to the investigation and prevention of anaesthetic mortality appears both rational and urgent. The benefits of an investigatory system, focused on subsequent safety rather than present liability and standardized through International Conventions, are well established in the air transport industry. We urge the involvement of persons with political and legal expertise in the development of an International Convention for the Investigation and Prevention of Anaesthetic Mortality.