Surgical ethics : principles and practice

✍ Scribed by Alberto R. Ferreres (ed.)

• Publisher: Springer
• Year: 2019
• Tongue: English
• Leaves: 313
• Edition: 1
• Category: Library

✦ Table of Contents

Preface
Contents
Contributors
Part I: Principles and Foundations of Surgical Ethics
History and Development of Medical Ethics In the West
Introduction: From Professional Ethics to Bioethics
Emergence of Medical Ethics, But Not Yet Bioethics
The Beginning of Bioethics
Conclusion: The Role of the Bioethicist
Concluding Remarks
Bibliography
Suggested Literature
The History of Surgical Ethics
Introduction
Birth of Modern Ethics
John Gregory (1724–1773)
Thomas Percival (1740–1804)
Birth of Modern Surgery
Surgical Ethics
Informed Consent
Transplant Surgery
Surgical Innovation
Surgical Ethics Today
Conclusion
Concluding Remarks
Glossary
References
Suggested Literature
Surgical Ethics: Theory and Practice Background
What Does It Mean for a Practicing Surgeon to Be “Ethical”?
Where Is “Ethics” in the Complexities of Patient Care?
Why Do Well-Intentioned Individuals Come to Conflicting Judgments About What Should Be Done?
What Are Patients and Their Families Invited to Trust?
When/Why Does Trust Break Down in Patient Care?
When/How Should Patients and Their Families Be Involved in Decision-Making?
Why Is It So Hard to Keep Sense in Care at Life’s End?
Is Concern for Justice (Ir)Relevant at the Bedside?
“Who Cares…Really?”
Appendix 1
Appendix 2
Appendix 3
Appendix 4
References
Foundations and Principles of Surgical Ethics
Beneficence
Nonmaleficence
Respect for Autonomy
Justice
Concluding Remarks
References
The Ethical Challenges of Surgical Leadership
The Ethical Challenges of Surgical Leadership
Leaders and Followers
The Surgeon as a Leader
The Distinctive Attributes of the Surgical Leader
Ethics
Ethics Is Paramount to Leadership
Ethical Leadership
Teleological Assessment
Ethical Egoism
Utilitarianism
Altruism
Deontological Assessment
Virtue-Based Approach
Creating an Ethical Culture
Examining Bad Leadership
The Six Major Challenges of Leadership
Management of Power
Management of Privilege
Management of Information
Consistent Decision-Making
Loyalty
Responsibility
Ethical Decision-Making
Moral Sensitivity
Moral Judgment
Moral Focus
Moral Character
Summary
References
Suggested Reading
What Is Surgical Professionalism?
Paternalism Versus Patient Autonomy
Payment Model
The Rise of Technology in Medicine and Surgery
Commercialization of Health Care
Appropriate Limitations to Practice and Responsibility to Keep Up To Date
Fear of Malpractice Litigation
Failure of Systems-Based Practice
Self-Regulation: The Code of Silence
Competition
Conflict of Interest
Solutions
Concluding Remarks
References
Suggested Literature
Ethics in Academic Surgery
Introduction
Human Subjects Research
Historical Development
Ethical Requirements for Clinical Research
Informed Consent
Surgical Innovation
Research Integrity and Publication
Good Research Practices
Authorship
Conflicts of Interest
Mentorship
Conclusion: Ethics as a Continuing Endeavor
References
Suggested Reading
Ethical Issues of the Mentor-Mentee Relationship
Concluding Remarks
References
Surgical Ethics and the Surgical Societies: What Are We Doing?
Introduction
Professional Surgical Societies
Ethics in Surgical Professional Organizations
Controversies in How Surgical Societies Handle Ethical Issues
Concluding Remarks
References
Ethical Issues in Surgical Research
Historical Perspective
Unifying Principles of Ethical Research Conduct
Intrinsic Barriers to Ethical Surgical Research
Pathways to Ethical Innovation
Special Considerations
Quality Improvement
Communication During Informed Consent
Sham Procedures
Industry Relationships
Authorship
Ethical Concerns for the “Basic Science” Surgeon-Investigator
Concluding Remarks
Glossary
References
Suggested Literature
Surgical Ethics and Diversity
Introduction
Lessons Learned from Business
The Social Contract of Diversity
Issues with Diversity in Surgery
Healthcare Disparities
Surgical Workforce
Response from Healthcare
Cultural Barriers
Bias
Path Forward
Cultural Competence
A Personal Commitment to Diversity
Concluding Remarks
Glossary
References
Suggested Literature
Why and How to Teach Surgical Ethics?
Introduction
Why
How
Case-Based Format
Formal Curriculum
Incorporating Ethics into M&M
Conclusion
References
The Surgeon, the Patient, and the Healthcare System: Access, Equity, and Fairness
Introduction
Introduction to Terms
Just Access Within Nations
Institutions
Justice in Global Health
The Individual Surgeon’s Obligation
Conclusion
Works Cited
Ethics in Global Surgery
Introduction
The Burden of Surgical Disease
The Making of Essential Global Surgery
Quality of Surgical Care in LMICs
Organizational Ethics and Global Surgery
Assessing Ethical Issues in Global Surgery
Determining a Course of Action
References
The Anesthesiologist and the Surgeon: Two Professionals Sharing the Command of the Patient in the Operating Room
Introduction
Human Rights
Ethical Principles
Autonomy
Beneficence
Nonmaleficence
Justice
Health Equity
Professionalism
Leadership
Surgeon-Anesthesiologist Relationship and Aligned Goals
Different Perspectives and Viewpoints
High-Risk Patients
International Health Ethics
Summary
References
Part II: Surgical Ethics in Everyday Surgical Practice
The Surgeon-Patient Relationship: Built Upon Trust
Introduction
Trust
Trust in Medicine
System Trust
Physician Trust in the Patient
Recent Trends in Trust and  the Medical Profession
Special Aspects of Trust in Surgery
The Role of Communication
More than Words
Teaching Communication Skills
The Conclusion
References
The Transformation and Challenges of the Surgeon–Patient Relationship
Introduction
The Surgeon–Patient Relationship Is Unique
The Doctor–Patient Relationship: A Historical Perspective
The Surgeon–Patient Relationship: Legal Grounding
The Surgeon–Patient Relationship: Bioethical Underpinnings
The Principle of Autonomy in the Surgeon–Patient Relationship
The Principle of Justice in the Surgeon–Patient Relationship
The Surgeon–Patient Relationship: Other Conflicts of Interests and Obligations
The Surgeon–Patient Relationship: Emerging Challenges
The Surgeon–Patient Relationship: Ethics in Practice
References
Suggested Readings
The Surgical Decision-Making Process: Different Ethical Approaches
Decision Aids/Decision Support
Emergency Patients
Acute, Not Yet Emergent Patients
Elective Patients
Surgical Buy-In
Surgical Candidacy and Moral Agency
Surgeon as Mere Technician
Pediatric Patients
References
The Surgical Informed Consent Process: Myth or Reality?
The Informed Consent
The Components of Informed Consent
Preconditions
Information Provided to the Patient
Physician Disclosure
Patient Understanding
Patient Decision-Making
Consent
Concluding Remarks
References
Informed Consent and Disclosure of Surgeon Experience
Informed Consent
Informing the Patient
Obtaining Consent
Challenges in Informed Consent
Assessment of Competence
Disclosure of Surgeon Experience
Forecasting
Concluding Remarks
Glossary
References
Suggested Literature
The Pediatric Patient as a Self-Individual and Decision-Maker
The Complexity of the Medical Decision-Making
Health in the Pediatric Universe
The Ethical and Legal Status of the Minor
The Informed Consent Process in Pediatrics
Conclusions
Concluding Remarks
References
Suggested Literature
End of Life Issues
Beneficence
Non-maleficence
Respect for Autonomy
Justice
Fidelity
Concluding Remarks
References
Suggested Literature and Resources
Ethics and Surgical Innovation
Introduction
Innovation in Surgery
What Constitutes Surgical Innovation in Terms of Procedure/Technique?
Oversight of Innovation
Informed Consent
Device Development
Tracking Outcomes
Training and Credentialing in New Technologies
Working with Industry
Disclosures
Conclusions
References
Ethics and Breast Cancer
Information and Consent: Disclosure
Breast Conservation vs Mastectomy
Genetic Testing and Implications: Prophylactic Surgery
Access to Treatment in Resource Constrained Environments: Compliance with Guidelines
Ductal Carcinoma In Situ
Final Remarks
References
Ethical Issues in Pediatric Liver Transplantation
Introduction
Pediatric Liver Transplant
Conclusions
References
Suggested Bibliography
Ethical Issues in Cardiothoracic Surgery
Introduction
Ethical Frameworks
Limitations on Care, Withdrawal of Life-Sustaining Care, and Futile Care
Surgical Outcomes Databases
Innovation
Ethics in Cardiothoracic Surgical Education
Professionalism
End-of-Life Care
Conclusions
References
Ethics of Surgical Intervention in Jehovah’s Witness Patients
Introduction
Historical Background and Transfusion Beliefs of Jehovah’s Witnesses
Moral Framework
Beneficence
Autonomy
Nonmaleficence
Justice
Concluding Remarks
References
Ethical Issues in Bariatric Surgery
Introduction
Medicalization of Obesity
Discrimination and Prejudices
Information and Bariatric Surgery
Access to Bariatric Surgery
Psychosocial Assessment and Preoperative Weight Lost
Centers for Bariatric Surgery and Medical Education
New Procedures in Bariatric Surgery
Bariatric Surgery in Children and Teenagers
Medical Tourism and Bariatric Surgery
Body Contouring Surgery After Bariatric Surgery
Should We Deny Surgery for Benign Disorders to Patients with Obesity?
Conclusion
Bibliography
How to Solve Ethical Conflicts in Everyday Surgical Practice: A Toolbox
Introduction
Case Presentation
Preparing to Address an Ethical Dilemma
The Gathering of Information
Development and Framing of the Ethical Question
Models for Analysis
Beauchamp and Childress “Four Principles”
Autonomy
Beneficence
Non-maleficence
Justice
Case Application
Four-Box Model
Medical Indications
Preferences of Patients
Quality of Life
Contextual Features
Pellegrino Approach
Conclusion
References
Afterword
Index