Ethical considerations in orthopaedic surgery

Current Reviews in Musculoskeletal Medicine, 2015

Despite our recent attention to ethical issues in orthopedics, we are still faced with multiple conflicts of interest that continue to pose ethical dilemmas to the practicing physician. Using four case scenarios, we review the potential conflicts of interest and the dilemmas posed by these frequently encountered situations. The ethical conflicts confronted in resident training, the introduction of new technology, physician advertising, and the obligations of the sports team physician are reviewed and discussed. The basic principles of medical ethics, including acting for the good of the patients and doing no harm, are discussed in the context of the four case scenarios.

The surgeon is a unique medical professional in that “any operation performed harms before healing. Consequently, by striving to minimise this necessary temporary injury to the patient while maximising the therapy's curative potential, surgeons have forever engaged in ethical deliberations.” Surgeons are responsible for all activities related to patients' treatment and care in surgical units, and it is therefore important for them to act in the best and correct way toward patients, relatives, and colleagues.

Current problems in surgery, 2013

This monograph is designed to provide surgeons with a broad overview of the common ethical problems that they are likely to encounter in their daily practice. It also demonstrates a method for approaching these problems. Finally, it presents cases that illustrate some of these problems and provides guidance to finding rational solutions.

South-East Asian Journal of Medical Education, 2018

This review article is based on concepts of medical ethics related to the day-today practice of surgery. Over the last two decades, with the development of advanced surgical methods, robotic surgeries, or telesurgeries, etc. there is increased reporting of associated ethical issues as well. Nevertheless, the ethical issues encountered by surgeons are reasonably different and critical when compared to what physicians face during their practice. There are extensive deontology literatures available for physicians while the same is not available sufficiently for surgeons. In this review, we have discussed the common queries asked by practicing surgeons who had faced medico-legal litigation and had come to us for consultation. This discussion is made in the light of comparison with ethical issued faced by practicing physicians. In the practice of medicine just fulfilling the basic ethical requirements, e.g. autonomy, beneficence, non-maleficence, is often sufficient. However, for surgical practice the ethical requirement is beyond the level of such basic deontological requirements. Hence, in this paper we have tried to search and discuss all deontological dimensions of surgical practice, e.g. Normative ethics: concerned with a moral course of action for a surgical practice, Meta-ethics: concerning determining the truth and reference of moral values, and the Applied ethics: concerning what a person is obligated to do in a specific situation or a particular domain of action. Hopefully, these will be useful to guide the surgeons' behaviours in particular circumstances encountered during their surgical practice.

Revista do Colégio Brasileiro de Cirurgiões, 2020

Medical Clinics of North America, 2002

Ethics is the application of values and moral rules to human activities. Bioethics applies ethical principles and decision making to solve actual or anticipated dilemmas in medicine. Much like clinical practice, which relies on general rules and case-based experiences, bioethical reasoning relies on learned and accepted moral rules, prior bioethical decisions derived from thoughtful reflection, and unique factors in each individual situation. This method of case-based reasoning is termed casuistry, although physicians better know it as clinical reasoning [1]. The term ethics in this article refers to normative ethics, a type of practical activity through which we try to determine what we ought to do and how our institutions should function. Contemporary medical ethics is a tapestry that interweaves a range of philosophical theories. The following four clusters of moral ''principles'' are central to medical ethics: (1) autonomy (respecting the decision-making capacities of individuals), (2) nonmaleficence (avoiding the causation of harm), (3) beneficence (providing benefits and balancing benefits against risk and costs), and (4) justice (the fair distribution of benefits, risks, and costs). Historically, nonmaleficence and beneficence have played a central role in medical ethics, whereas respect for autonomy and justice were neglected in traditional medical ethics but have come into prominence in the last 30 years [2]. Autonomy is the most significant value that has been promoted by contemporary medical ethics. The acknowledgment of autonomy has served to discredit medical paternalism and has led to the promotion of the patient from recipient of treatment to being the partner in a treatment plan. However, the acceptance of autonomy as the benchmark of good has led us to Med Clin N Am 86 (2002) 869-886

Orthopedics, 2015

All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for ...

Postgraduate Medical Journal, 2006

Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria

Ethical problems routinely arise in the hospital and outpatient practice settings and times of dilemma do occur such that practitioners and patients are at cross-roads where choice and decision making become difficult in terms of ethics. This paper attempts a synopsis of the basic principles of medical ethics, identifies some ethical dilemmas that doctors often encounter and discusses some strategies to address them as well as emphasizes the need for enhanced ethics education both for physicians and patients particularly in Nigeria. Literature and computer programmes (Medline and PsychoInfo databases) were searched for relevant information. The search showed that the fundamental principles suggested by ethicists to assist doctors to evaluate the ethics of a situation while making a decision include respect for autonomy, beneficence, non-maleficence and justice. Although the above principles do not give answers as to how to handle a particular situation, they serve as a guide to doct...

The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.