10). But the reviewers certainly mentioned "the ethical and patient safety implications of randomly assigning nurses to cases, noting that "randomization may be unacceptable to health care providers, health care committees, etc. "research ethics and patients, particularly for high-risk patients and procedures." p. 15)” (ASAH.org)2) “It is difficult to determine who provides anesthesia care in studies and how many cases actually involve a physician anesthesiologist (p. 11)” ASA says the data collected and used in this review, are difficult to determine who did what and when. In other words, it is not clear who was performing and providing the care in these studies and it could very well be the care provided by an anesthesiologist. They also say that the data provided and used by the study included limiting factors in determining whether an anesthesiologist was available when needed, to rescue or advise a patient being treated by a nurse anesthetist should they experience complications under treatment..