he ASA Board of Directors held its annual meeting in Chicago, Illinois, on Saturday and Sunday, August 19-20, 2006. The Board committees on Administrative Affairs, Finance, Legislative Review and Scientific Affairs held open hearings on Saturday to review reports for consideration by the Board of Directors on Sunday. Among the actions taken by the Board of Directors were the following, subject to House of Delegates ratification:

Nonanesthesiologists, Moderate Sedation and Deep Sedation
The Board voted to approve a document, “Statement on Granting Privileges for Administration of Moderate Sedation to Practitioners Who Are Not Anesthesia Professionals,” which is a refinement of a similar document approved by the 2005 House of Delegates.

The ad hoc committee charged with drafting these statements presented the Board with two distinctly different choices for granting privileges for deep sedation.

The Board voted to endorse the statement that supports the principle that the administration of deep sedation should be limited to anesthesia professionals:

“Because of the significant risk that patients who receive deep sedation many inadvertently enter a state of general anesthesia, privileges to administer deep sedation should be granted only to practitioners who are qualified to administer general anesthesia or to appropriately supervised anesthesia professionals.”

The alternative statement, which was not approved by the Board, describes suggested criteria for granting privileges to appropriately trained nonanesthesiologist practitioners (e.g., other physicians, dentists, podiatrists) to administer deep sedation, either personally or while supervising an appropriately trained nonanesthesia professional (e.g., registered nurse, sedation nurse).

All three statements will be presented to the House of Delegates in October.

The Board commented that due to the complexity of this subject matter, the House and its Reference Committee may wish to recommend that no amendments to either statement be permitted at the House meeting and that disposition of these two documents be restricted to approval, disapproval or referral, without amendments from the floor.

Revised Anesthesia Care Team Statement
There was extensive discussion on a revised statement on the anesthesia care team. The matter was referred to the Committee on Anesthesia Care Team for submission of a final revised document to the 2006 House of Delegates.

Physician Nonparticipation in Executions
Approved an amended “Statement on Physician Nonparticipation in Legally Authorized Executions” presented by the Committee on Ethics, with the comment that ASA is well-served ethically and publicly by ASA’s current position in support of the American Medical Association’s (AMA’s) ethical guidelines. The proposed statement reads:

1. Execution by lethal injection has resulted in the incorrect association of capital punishment with the practice of medicine, particularly anesthesiology.

2. Although lethal injection mimics certain technical aspects of the practice of anesthesia, capital punishment in any form is not the practice of medicine.

3. Because of ancient and modern principles of medical ethics, legal executions should not necessitate participation by an anesthesiologist or any other physician.

4. ASA continues to agree with the position of AMA on physician noninvolvement in capital punishment. ASA strongly discourages participation by anesthesiologists in executions.

Membership E-Mail Addresses
Approved a proposed Administrative Procedure that would allow component societies or tax-exempt educational institutions offering continuing medical education (CME) programs to obtain, for a fee, a list of ASA members’ e-mail addresses to use on a one-time basis to promote their CME meetings. Members would have the option of opting out of CME e-mail announcements.

Updated Practice Guidelines for Obstetric Anesthesia
Heard testimony on the draft of the updated Practice Guidelines for Obstetric Anesthesia, prepared by a task force chaired by Joy A. Hawkins, M.D. These guidelines will be considered by the House of Delegates at its October 2006 meeting. Practice parameters currently under development or revision will address transesophageal echocardiography, chronic pain, cancer pain and preoperative fasting (updates), neuraxial anesthesia (new) and operating room fires (new).

New Committee on Simulation Education
Approved a recommendation to form a new standing Committee on Simulation Education. The duties of the new committee would include establishing criteria and processes for approving simulation programs and facilitating the use of simulation for offering CME to ASA members.

“Annual Meeting Highlights” CME Offering
Approved a new CME program that would offer members the opportunity for CME via select Webcasts of Annual Meeting lectures and presentations, with a post-test at the end of each presentation. This new program is anticipated to be available on the Internet by January 2007.

Committee on Economics
Approved a recommendation from the Committee on Economics to revise the Statement on Transesophageal Echocardiography, approved by the House in 2001 and last amended in 2005. This is not the Practice Guidelines for Perioperative Transesophageal Echocardiography.

2007 Budget and Dues
Approved a 2007 budget to provide total income of $25,035,625 and total expenses of $24,877,200. The 2007 budget includes funding for the Anesthesia Patient Safety Foundation (APSF), the Foundation for Anesthesia Education and Research (FAER) and the Wood Library-Museum of Anesthesiology (WLM) as follows:

APSF - $500,000

FAER - $1,500,000

WLM - $400,000

Recommended that the House of Delegates approve the following 2007 membership dues, which are unchanged from 2006:

Active Members - $450

Affiliate Members - $225

Educational Members - $225

Resident Members - $25

Educational Student Members - $25

Medical Student Members - $10

President’s Council on Executive Office Oversight
Approved a recommendation from the Administrative Council to establish a new President’s Council on Executive Office Oversight to assist the President in providing member oversight of and assistance to the ASA executive staff.  The Board of Directors requested a report from the President in August 2007 on the progress and efficacy of this new council and its related administrative procedures.

New Potential Conflict-of-Interest Disclosure Statement
Approved a recommendation from the Administrative Council to initiate the use of an expanded potential conflict-of-interest statement that would assist those individuals in the service of ASA to better define material financial interests that would warrant disclosure.