The provision of health services has been transforming from a largely top-down, paternalistic model into a construct in which patients play a substantive role in decision making over their care. Two articles in this month’s issue of Anesthesia & Analgesia and an accompanying editorial address the growing momentum behind transparency in health care. Firstly, Quinonez et al consider the increasing expectation of family presence during surgical procedures and resuscitation of loved ones. They entertain the valid merits of family presence, such as the anxiolytic effect it may have as well as increased understanding of procedural goals and enhanced staff professionalism. Conversely, family members may not be psychologically prepared to bear witness to more invasive clinical environments and may serve as a source of distraction to providers. The impact of family presence on medical litigation is unclear. There have been long standing precedents set by way of obstetric and pediatric populations as seen in this infographic. In conjunction with the increased desire for physical presence of loved ones during clinical procedures, so too is there a demand for complete access to all medical records, including even the arcane hieroglyphics of an anesthesia record as detailed by Ramaswamy et al. As federal law now mandates such access, questions naturally arise as to their utility and medicolegal implications. The reader is strongly encouraged to review the concepts elaborated in these articles for in depth appreciation of their considerations.

卫生服务的提供已经从一种自上而下的家长式模式转变为一种结构，在这种结构中，患者在其护理决策中发挥实质性作用。本月Anesthesia & Analgesia两篇文章以及随附的社论讨论了医疗保健透明度背后日益增长的势头。首先，Quinonez 等人考虑到在外科手术和亲人复苏过程中家人在场的期望越来越高。他们接受家庭存在的有效优点，例如它可能具有的抗焦虑作用以及对程序目标的更多理解和增强的员工专业精神。相反，家庭成员可能没有心理准备来见证更具侵入性的临床环境，并可能成为提供者分心的来源。家庭存在对医疗诉讼的影响尚不清楚。如本信息图所示，产科和儿科人群已经建立了长期的先例。随着临床过程中对亲人亲临现场的需求增加，也需要完全访问所有医疗记录，甚至包括 Ramaswamy 等人详述的麻醉记录的神秘象形文字。由于联邦法律现在规定了此类访问，因此自然会出现有关其效用和法医学意义的问题。强烈鼓励读者回顾这些文章中阐述的概念，以深入了解它们的考虑。