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New Law Clarifies ‘Informed Consent’ Related to Anesthesia Care

Pennsylvania Association of Nurse Anesthetists


CONTACT: Kurt Knaus; P: 717-724-2866; E:

New Law Clarifies ‘Informed Consent’ Related to Anesthesia Care

Act address unintended consequences of 2017 Supreme Court ruling

HARRISBURG (July 1, 2021) --- Gov. Tom Wolf has enacted a new law that remedies the years-long fallout from a complex ruling by the state’s top court that had the unintended consequence of restricting the administration of anesthesia.

Issues related to “informed consent” were brought about by the state Supreme Court’s interpretation of the Medical Care Availability and Reduction of Error (MCare) Act, under the Shinal v. Toms case, regarding a physician’s ability to delegate the duty to obtain the informed consent of a patient prior to specified procedures.

The court’s interpretation, part of a June 20, 2017, ruling, impacted patient care by ruling that only a physician can obtain informed consent.

The ruling had a profound effect on advanced practice providers like certified registered nurse anesthetists, especially those who work without physician anesthesiologists, because it made the surgeon, who is not an anesthesia expert, responsible for talking to a patient about anesthesia care and obtaining their consent.

Anesthesia teams comprising CRNAs and anesthesiologists also were affected. In many cases, CRNAs would obtain their own consents prior to the ruling. But after the court handed down its decision, anesthesiologists had to pulled off other tasks to perform this duty, affecting workplace flow for patient care.

This new law essentially clarifies that while physicians remain responsible for the overall care of their patients, the task of obtaining a patient’s informed consent may be delegated by a physician to a qualified practitioner, including CRNAs.

“We heard from CRNAs across Pennsylvania over the years how this ruling really affected day-to-day procedures, making their work more challenging and causing confusion among patients during what is already a stressful time,” said Matt McCoy, DNP, CRNA, President of the Pennsylvania Association of Nurse Anesthetists (PANA), which represents more than 3,700 CRNAs and students in the commonwealth.

The measure (S.B. 425), sponsored by state Sen. John Gordner (R-Columbia), received unanimous approval in both the Senate and House. With the governor’s signature, the legislation now becomes Act 61 of 2021.

For more information about certified registered nurse anesthetists in Pennsylvania, visit or follow along on social media via Twitter at @PANACRNA or on Facebook at



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