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The first textbook on the subject, this is a practical, clinically comprehensive guide to ethical issues in surgical practice, research, and education written by some of the most prominent figures in the fields of surgery and bioethics. Discussions of informed consent, confidentiality, and advance directives--core concepts integral to every surgeon-patient relationship--open the volume. Seven chapters tackle the ethical issues in surgical practice, covering the full range of surgical patients--from emergency, acute, high-risk, and elective patients, to poor surgical risk and dying patients. The book even considers the special relationship between the surgeon and patients who are family members or friends. Chapters on surgical research and education address innovation, self-regulation in practice and research, and the prevention of unwarranted bias. Two chapters focus on the multidisciplinary nature of surgery, including the relationships between surgery and other medical specialties and the obligations of the surgeon to other members of the surgical team. The economic dimensions of surgery, especially within managed care, are addressed in chapters on the surgeons financial relationships with patients, conflicts of interest, and relationships with payers and institutions. The authors do not engage in abstract discussions of ethical theory; instead, their discussions are always directly relevant to the everyday concerns of practicing surgeons. This well-integrated volume is intended for practicing surgeons, medical educators, surgical residents, bioethicists, and medical students.
According to popular belief, technical skill is far more important for surgeons than thoughtful deliberation. Nothing could be further from the truth. Although surgeons must sometimes make decisions rapidly on the basis of incomplete evidence and must respond to unexpected catastrophes in the operating room rapidly, those events are intermittent - most of the time surgeons deliberate on diagnostic problems and thoughtfully manage postoperative care, which is often intellectually challenging.The relationship of surgeons with their patients is, in a real sense, far more intimate and trusting than that of any other professional, a claim that is supported by the fact that patients surrender their bodies to their surgeons in a state of total helplessness and vulnerability when they undergo anesthesia. Because of that responsibility, no other professional group has a greater sense of dedication to the welfare of their patients than surgeons.Surgical culture is deeply steeped in ethics, and surgeons confront and resolve ethical dilemmas as much or more than most other professionals, although they often may not recognize the situations they resolve are problems in ethics - they are just part of the daily routine. This book is a compendium of articles from the recent surgical literature that address ethical issues chosen by surgeons because they are controversial and pertinent to the practice of surgery. The reader will not find a great deal of sophisticated dissection of fine philosophical distinctions in these discussions of ethical conflicts and controversies in surgery. Instead, they will discover differing viewpoints from thoughtful essayists, mostly surgeons, whose feet are firmly in contact with the ground and who have extensive experience in the real world of surgery, medicine, and law.
This book provides a detailed guide to the ethical considerations involved when making decisions in surgery. Chapters feature a uniform format, which feature a case that represents a real-life problem, discussion of the medical indications of that issue, the latest available medical solutions, and related ethical considerations. In some cases, more in-depth debate is provided on why a particular decision should or should not be made based-upon ethical principles. Information boxes containing key statements and relevant data in clear easy-to-digest tables facilitates the reader in being able to assimilate the most important points covered in each chapter. Difficult Decisions in Surgical Ethics: An Evidence-Based Approach is a thorough review of ethical considerations in a range of surgical scenarios encompassing both adult and pediatric topics, training surgical residents, ethical care during a pandemic, critical care, palliative care, sensitivity to religious and ethnic mores, clinical research, and innovation. It is intended to be a vital resource for practicing and trainee surgeons seeking a comprehensive up-to-date resource on ethical topics in surgical practice. The work is part of the Difficult Decisions in Surgery series covering a range of surgical specialties.
This book encompasses the theoretical and practical aspects of surgical ethics, with a focus on the application of ethical standards to everyday surgical practice and the resolution of ethical conflicts in the surgical arena. It provides surgeons (both prospective and practicing) in the different surgical fields with deep, practical insights into the topic. A 21st century surgeon requires complete competence (superb clinical skills, expert surgical decision-making and outstanding performance and technical skills) as well as solid ethical values. Ethics are placed at the core of surgical professionalism, so surgeons must be not only proficient and expert but also ethically and morally reliable. Surgical decision-making can be considered as a two-step process: the “how to treat” aspect is a matter of surgical science, while “why to treat” issues are a matter of surgical ethics and are based on ethical principles. As such, every surgeon should have a moral compass to guide his or her actions, always placing the welfare and rights of the patients above their own. The book provides invaluable background and insights for solving the ethical conflicts surgeons around the globe encounter in their daily practice. Each chapter will also include features such as key point summaries in the beginning of the chapters, explanatory boxes, a glossary and suggested readings. Surgical Ethics - Principles and Practice is an authoritative work in the field designed for experienced surgeons, surgical residents, and fellows, all of whom are confronted with ethics issues and conflicts in practice.
Contributors. -- Foreword. -- Preface. -- Getting Started. -- Assessing Available Information. -- Organizing and Preliminary Planning for Surgical Research -- Writing a Protocol: Animals, Humans, and Use of Biologic, Chemical, and Radiologic Agents. -- Grantsmanship. -- Informed Consent and the Protection of Human Research Subjects: Historical Perspectives and Guide to Current United States Regulations. -- Animal Care and Maintenance. -- Funding Strategies and Agencies: Academic-Industrial Relationships; Intellectual Property. -- Statistical Considerations. -- Use of Nonexperimental Studies to Evaluate Surgical Procedures and Other Interventions: The Challenge of Risk Adjustment. -- Measuring Surgical Outcomes. -- Design of Clinical Trials. -- Using Administrative Data for Clinical Research. -- Research in the Intensive Care Unit: Ethical and Methodological Issues. -- Research in the Operating Room. -- Effects of Age and Gender. -- Strategies, Principles, and Techniques Using Transgeni ...
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Over the last quarter of a century, the fields of medical ethics and of legal issues related to medical practice have rapidly developed for a number of reasons. Firstly, the provision of healthcare nowadays is based on a complicated partnership between healthcare providers, patients, administrators and organizations responsible for providing finance; this complicated partnership frequently results in clashes of views, opinions, and priorities, which have a major ethical and legal dimension. Secondly, a major event of the 21st century is the development of multicultural societies; healthcare-related decisions thus have to be made on the background of so many different ethnicities, religions, cultures and languages, resulting in a great spectrum of ethical and legal implications. Thirdly, in the modern world, people are more mobile and can easily and cost-effectively seek treatment outside of their country of origin or residence, which raises many ethical and legal issues. Lastly, the development of new medical specialties, modern and advanced treatments for very challenging patients, and the introduction of new technologies in medical practice have dramatically broadened the spectrum of ethical and legal issues related to medical practice. This book will therefore aim to cover in detail general principles and specific issues related to the ethical and legal dimensions of modern surgical practice.
Natural disasters and cholera outbreaks. Ebola, SARS, and concerns over pandemic flu. HIV and AIDS. E. coli outbreaks from contaminated produce and fast foods. Threats of bioterrorism. Contamination of compounded drugs. Vaccination refusals and outbreaks of preventable diseases. These are just some of the headlines from the last 30-plus years highlighting the essential roles and responsibilities of public health, all of which come with ethical issues and the responsibilities they create. Public health has achieved extraordinary successes. And yet these successes also bring with them ethical tension. Not all public health successes are equally distributed in the population; extraordinary health disparities between rich and poor still exist. The most successful public health programs sometimes rely on policies that, while improving public health conditions, also limit individual rights. Public health practitioners and policymakers face these and other questions of ethics routinely in their work, and they must navigate their sometimes competing responsibilities to the health of the public with other important societal values such as privacy, autonomy, and prevailing cultural norms. This Oxford Handbook provides a sweeping and comprehensive review of the current state of public health ethics, addressing these and numerous other questions. Taking account of the wide range of topics under the umbrella of public health and the ethical issues raised by them, this volume is organized into fifteen sections. It begins with two sections that discuss the conceptual foundations, ethical tensions, and ethical frameworks of and for public health and how public health does its work. The thirteen sections that follow examine the application of public health ethics considerations and approaches across a broad range of public health topics. While chapters are organized into topical sections, each chapter is designed to serve as a standalone contribution. The book includes 73 chapters covering many topics from varying perspectives, a recognition of the diversity of the issues that define public health ethics in the U.S. and globally. This Handbook is an authoritative and indispensable guide to the state of public health ethics today.
Neurosurgical interventions have the potential to change a person's concept of self, as well as affect their neurological and cognitive function to an unacceptable level for both patient and family. In an increasingly complex and evolving field, the ethical implications of treatments and their eventual outcomes must be carefully balanced. Ethics in Neurosurgical Practice is a comprehensive and practical guide for managing the treatment of patients with debilitating neurosurgical conditions. Chapters address specific conditions, such as traumatic brain injuries, ischemic stroke and spinal surgery, and the ethical challenges that each of these pose. Detailed case studies present potential scenarios that readers might encounter, and their outcomes. Future developments of this fast-paced field are expanded upon, including televised live surgery and the ethical aspects of innovation in neurosurgery. A broad variety of contributors in different fields, including neurosurgeons, intensivists and bioethicists, ensures comprehensive coverage from a range of views and experiences.