22/10/2025
WHEN AUTHORITY OVERRIDES EXPERTISE
In healthcare, there’s a quiet tension that many people never see.
It happens behind closed doors, in operating rooms, wards, and corridors.
It’s not always about emergencies or equipment failure.
Sometimes, it’s about decisions,
decisions that test ethics, courage, and professional boundaries.
Not every order from above is the right one.
And not every No, we can’t proceed means someone is being difficult.
In medicine, those few words can mean the difference between safety and sorrow.
When an anesthetist says, Let’s postpone this surgery…
it’s rarely out of pride or ego.
It’s out of protection for the patient, for the team, and for the system itself.
An anesthetist reads the body in ways most people don’t notice.
They look beyond the numbers on a monitor.
They see patterns in the oxygen saturation, the bl00d pressure, the lab values, and the patient’s overall condition.
They know when the body is whispering, Not yet.
So when they recommend a pause,
it’s not punishment.
It’s a professional instinct guided by training, science, and experience.
But sometimes, that judgment collides with authority.
Someone higher up who may not fully grasp the risk gives a directive to proceed.
And suddenly, the anesthetist is caught in an ethical dilemma…
follow an order, or follow their conscience.
Because here’s the truth…
when things go wrong in a theatre,
no one remembers the order from above.
The questions, the investigations, the accountability…
they all point back to the name written on the anesthesia chart.
That’s why anesthetists are cautious.
That’s why they double check everything.
That’s why some cases are delayed, and some are stopped entirely.
It’s not stubbornness.
It’s responsibility.
Every time an anesthetist signs a pre operative form,
they are not just signing for anesthesia, they are signing for a life.
Ethical dilemmas like these test the very soul of healthcare.
Do you obey hierarchy?
Or do you protect the patient at all costs?
Do you stay silent?
Or do you speak up, knowing the backlash might follow?
Many professionals have stood in that moment, heart racing, hands steady, ethics louder than fear…. choosing safety over approval.
Because real healthcare is not about who gives the loudest instruction,
it’s about who listens to the patient’s silent signs.
So next time you hear that a surgery was delayed or postponed because the anesthetist said so, pause before you judge.
Ask why….
That “why” might hold the wisdom that saves a life.
Respect the expertise of those who watch over the unconscious, who carry the weight of every breath and heartbeat in the theatre.
Because when authority overrides expertise, patient safety becomes the silent casualty.
I am De Wesley's | Surgical Patients’ Advocate | Creating Awareness | Saving Lives.