The Helsinki Declaration was also the subject of an article published in the EJA.

European Journal of Anaesthesiology:
July 2010 – Volume 27 – Issue 7 – p 592–597
doi: 10.1097/EJA.0b013e32833b1adf
Special article

Anaesthesiology shares responsibility for quality and safety in Anaesthesia, Intensive Care, Emergency Medicine and Pain Medicine, including the whole perioperative process and also in many other situations inside and outside the hospital where patients are at their most vulnerable.

  • Around 230 million patients undergo anaesthesia for major surgery in the world every year. Seven million develop severe complications associated with these surgical procedures from which one million die (200,000 in Europe).1 All involved should try to reduce this complication rate significantly.
  • Anaesthesiology is the key specialty in medicine to take up responsibility for achieving the goals listed below which will notably improve Patient Safety in Europe.


Heads of Agreement

We, the leaders of societies representing the medical speciality of anaesthesiology, met in Helsinki on 14 June 2010 and all agree that:

  • Patients have a right to expect to be safe and protected from harm during their medical care and anaesthesiology has a key role to play improving patient safety perioperatively. To this end we fully endorse the World Federation of Societies of Anaesthesiologists International Standards for a Safe Practice of Anaesthesia.
  • Patients have an important role to play in their safe care which they should be educated about and given opportunities to provide feedback to further improve the process for others.
  • The funders of healthcare have a right to expect that perioperative anaesthesia care will be delivered safely and therefore they must provide appropriate resources.
  • Education has a key role to play in improving patient safety, and we fully support the development, dissemination and delivery of patient safety training.
  •  Human factors play a large part in the delivery of safe care to patients, and we will work with our surgical, nursing and other clinical partners to reliably provide this.
  •  Our partners in industry have an important role to play in developing, manufacturing and supplying safe drugs and equipment for our patients’ care.
  • Anaesthesiology has been a key specialty in medicine leading the development of patient safety. We are not complacent and know there are still more areas to improve through research and innovation.
  • No ethical, legal or regulatory requirement should reduce or eliminate any of the protections for safe care set forth in this Declaration.

Principal requirements

Today we pledge to join with the European Board of Anaesthesiology (EBA) in declaring the following aims for improving Patient Safety in Europe. Close cooperation between European organisations will be required to achieve these goals, for which the input and efforts of the European Society of Anaesthesiology (ESAIC) will be instrumental:

  1. All institutions providing perioperative anaesthesia care to patients (in Europe) should comply with the minimum standards of monitoring recommended by the EBA both in operating theatres and in recovery areas.
  2. All such institutions should have protocols and the necessary facilities for managing the following
    • Preoperative assessment and preparation
    • Checking Equipment and drugs
    • Syringe labelling
    • Difficult/failed intubation
    • Malignant hyperpyrexia
    • Anaphylaxis
    • Local anaesthetic toxicity
    • Massive haemorrhage
    • Infection control
    • Postoperative care including pain relief
  3. All institutions providing sedation to patients must comply with anaesthesiology recognised sedation standards for safe practice.
  4. All institutions should support the WHO Safe Surgery Saves Lives initiative and Checklist.
  5. All departments of anaesthesiology in Europe must be able to produce an annual report of measures taken and results obtained in improving patient safety locally.
  6. All institutions providing anaesthesiological care to patients must collect the required data to be able to produce an annual report on patient morbidity and mortality.
  7. All institutions providing anaesthesiological care to patients must contribute to the recognised national or other major audits of safe practice and critical incident reporting systems. Resources must be provided to achieve this.


This declaration emphasises the key role of anaesthesiology in promoting safe perioperative care.


We invite anyone involved in healthcare to join us and sign up to this declaration.

We will reconvene to annually review our progress to implement this declaration.