As anesthesiologists, we regularly make decisions affecting the health and well-being of our patients. Our decisions are based upon outcomes-oriented evidence, generally accepted scientific concepts and expert opinion. Many of these decisions require “thinking through” the risks and benefits of our actions, and then choosing the path that best serves our patients and minimizes potential harm.

For example, hand hygiene is facilitated by having alcohol-based hand rub near patient care areas. Better hand hygiene means fewer potential pathogens are transmitted by contaminated hands. On the other hand, alcohol-based hand rubs may increase the potential for fires in a setting where oxygen is being delivered and electrocautery is in use. Both views are accurate, and we must decide the best course of action.

When making these decisions, how are we to appraise harm to a single patient versus harm to...

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