Family members sometimes ask (or are asked) to assist the anesthesia provider. This is understandable; most families genuinely wish to be helpful to the provider and attentive to and supportive of the patient. Remember, however, that during any kind of illness (and especially one requiring surgical intervention), family members often feel they have relinquished control of their loved one to a process that is both unfamiliar and threatening. Thus, the family may feel more stress and helplessness than the patient. Under these conditions, it is almost never a good idea to put the family “to work.” It isn’t fair to them and it creates both medical and legal problems. The primary role of the family should be to provide emotional support to the patient. The only exception occurs with the pediatric population, in whom the calming influence of parents can almost always be beneficial, and the parents may be asked (depending on the culture of the hospital) to carry the patient into the operating room (OR) and to provide “cradling” assistance during induction.

Today, virtually all hospitals serve a population that is culturally diverse. This has increased the frequency of non-English-speaking patients requiring anesthetic care. Often, a family member will volunteer to assist with translation and, given scheduling pressures in the operating room, it is common to allow this practice rather than waiting for an official hospital translator. This does not meet the standard for either informed consent or confidentiality requirements. Informed consent requires that the patient or his or her legal representative be presented the risks and benefits of anesthesia based on the patient’s medical condition(s). Informed consent is more than a signature on a piece of paper; it is an actual exchange of information. When using a family member to translate, it is impossible to know that all information was adequately and, more important, accurately translated in a manner that would satisfy the legal requirements of the informed consent process. As such, having an official translator for the informed consent conversation is the best course of action. The anesthesia preoperative evaluation should clearly list the name of the hospital translator. If the situation is so urgent that it cannot be held until an official translator is present or the language is so obscure that a translator is not available, the official documentation
should reflect this and the emergency/urgent nature of the impending surgery or procedure should be specifically noted. The hospital translator also serves the secondary purpose of ensuring that the patient is able to have a confidential (at least as far as the family is concerned) preoperative interview.