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Taylor Kinsley
Former Undergraduate Student
Department of Biological Sciences
Kean University
Under the Knife and Completely Aware: A Case of Intraoperative Awareness

This case study is based on a newspaper article about the suicide of Sherman Sizemore shortly after he underwent an exploratory laparotomy (abdominal surgery).  After his surgery, Sherman experienced symptoms similar to post-traumatic stress disorder (PTSD) including nightmares, paranoia, depression, insomnia, and dramatic mood swings. Sherman's family later discovered that he had been awake during the first part of the surgery; although given a muscle relaxer, he was never administered an anesthetic. Sherman was never told that he had been awake during surgery or that he had been given an amnesic to suppress memory of the traumatic event.  The condition that Sherman experienced is variously called intraoperative awareness (IOA) or anesthesia awareness. This case study explores the moral, ethical, and biological issues relevant to IOA by using role play and the device of a fictional mediation between three stakeholder groups: Sherman's family, the anesthesiologist group that administered the anesthetic, and the hospital and lead surgeon who conducted the surgery. The case is suitable for use in a wide variety of courses including medical ethics, psychology, abnormal psychology, introductory biology, anatomy, and physiology.