The Ethics of Surgery: Conflicts and Controversies

Paperback | February 24, 2015

EditorRobert M. Sade

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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 theoperating 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 undergoanesthesia. 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 acompendium 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 discussionsof 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.

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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 theoperating room rapidly, those events are int...

Robert M. Sade, MD, is Distinguished University Professor, Professor of Cardiothoracic Surgery and Director of the Institute of Human Values in Health Care at the Medical University of South Carolina, where he also is Director of the Clinical Research Ethics Program. At MUSC, he created the Section of Pediatric Cardiac Surgery in 1975 ...

other books by Robert M. Sade

Format:PaperbackDimensions:384 pages, 9.21 × 6.1 × 1.3 inPublished:February 24, 2015Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0190204524

ISBN - 13:9780190204525

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Table of Contents

ContributorsRobert M. Sade, MD: IntroductionSECTION 1: THE PROBLEM OF SURGICAL ETHICS1. Robert M. Sade, MD, Timothy H. Williams, MD, David J. Perlman, MA, Cynthia L. Haney, JD, and Martha R. Stroud, MS: Ethics Gap in Surgery2. Thomas A. D'Amico, MD, Martin F. McKneally, MD, and Robert M. Sade, MD: Ethics in Cardiothoracic Surgery: A Survey of Surgeons' ViewsSECTION 2: PROFESSIONAL INTEGRITY3. Robert M. Sade, MD: Deceiving Insurance Companies: New Expression of an Ancient Tradition4. Carolyn M. Dresler, MD, MPA, Michael S. Kent, MD, Richard I. Whyte, MD, MBA, Robert M. Sade, MD: Hepatitis C Virus-Infected Resident: End of Residency, End of Career?5. Eric R. Skipper, MD, Kevin D. Accola, MD, and Robert M. Sade, MD: Must Surgeons Tell Mitral Valve Repair Candidates About a New Percutaneous Repair Device That Is Only Available Elsewhere?6. Jamie Dickey, PhD, Ross M. Ungerleider, MD, Joseph S. Coselli, MD, Lori D. Conklin, MD, Robert M. Sade, MD: The Surgeon's Work in Transition: Should Surgeons Spend More Time Outside the Hospital?7. Charles A. Czeisler, PhD, MD, Carlos A. Pellegrini, MD, and Robert M. Sade, MD: Should Sleep-Deprived Surgeons Be Prohibited From Operating Without Patients' Consent?8. Donald C. Watson, Jr, MD, Francis Robicsek, MD, PhD, Robert M. Sade, MD: Are Thoracic Surgeons Ethically Obligated to Serve as Expert Witnesses for the Plaintiff?SECTION 3: RELATIONSHIPS WITH PATIENTS - AUTONOMY AND CONSENT9. Keith S. Naunheim, MD, Charles R. Bridges, MD, ScD, and Robert M. Sade, MD: Should a Jehovah's Witness Patient Who Faces Imminent Exsanguination Be Transfused?10. Thomas A. D'Amico, MD, Mark J. Krasna, MD, Diane M. Krasna, CRNA, Robert M. Sade, MD: No Heroic Measures: How Soon Is Too Soon to Stop?11. Constantine Mavroudis, MD, Constantine D. Mavroudis, MD, Keith S. Naunheim, MD, and Robert M. Sade, MD: Should Surgical Errors Always Be Disclosed to the Patient?12. Susan D. Moffatt-Bruce, MD, PhD, Chadrick E. Denlinger, MD, Robert M. Sade, MD: Another Surgeon's Error: Must You Tell the Patient?13. Anthony L. Estrera, MD , Sharon Ikonomidis, PhD, John S. Ikonomidis, MD, Robert M. Sade, MD: Impending Loss of Insurance Coverage is an Indication to Proceed With Complex, Expensive Surgery14. J. Michael DiMaio, MD, Tomas A. Salerno, MD, Ron Bernstein, JD, Katia Araujo, PsyD, Marco Ricci, MD, Robert M. Sade, MD: Ethical Obligation of Surgeons to Noncompliant Patients: Can a Surgeon Refuse to Operate on an Intravenous Drug-Abusing Patient With Recurrent Aortic Valve ProsthesisInfection?SECTION 4: INNOVATION AND USES OF TECHNOLOGY15. Haavi Morreim, PhD,, Michael J. Mack, MD, Robert M. Sade, MD: Surgical Innovation: Too Risky to Remain Unregulated?16. Jessica K. Smyth, MD, Karen E. Deveney, MD, Robert M. Sade, MD: Who Should Adopt Robotic Surgery, and When?17. Joseph E. Bavaria, MD, Philip Green, MD, Gregg F. Rosner, MD, Martin B. Leon, MD, Allan Schwartz, MD, Robert M. Sade, MD: Should Access to Transcatheter Aortic Valve Replacement Be Limited to High-Volume Surgical Centers?18. John E. Mayer, Jr, MD, Grayson H. Wheatley III, MD, Robert M. Sade, MD: Should the Use of Transcatheter Aortic Valve Implantation be Rationed?SECTION 5: ORGAN DONATION AND TRANSPLANTATION19. Franklin G. Miller, PhD, Robert M. Sade, MD: Heart Donation Without the Dead Donor Rule20. Benjamin Hippen, MD, Lainie Friedman Ross, MD, Robert M. Sade, MD: Saving Lives Is More Important Than Abstract Moral Concerns: Financial Incentives Should Be Used to Increase Organ Donation21. Shu S. Lin, MD, PhD, Lauren Rich, RN, BSN, Jay D. Pal, MD, PhD, Robert M. Sade, MD: Prisoners on Death Row Should Be Accepted as Organ DonorsSECTION 6: CONFLICTS OF INTEREST IN SURGERY22. Kenneth V. Iserson, MD, MBA, Robert James Cerfolio, MD, Robert M. Sade, MD: Politely Refuse the Pen and Note Pad: Gifts From Industry to Physicians Harm Patients23. Stephen J. Immelt, JD, Vincent A. Gaudiani, MD, Robert M. Sade, MD: Should the Financial Link Between Industry and Physician Consultants Be Severed?24. J. Peter Murphy, MD and Robert M. Sade, MD: Full Disclosure-Should Presentations and Publications Include Dollar Amounts and Duration of Surgeon-Industry Relationships?SECTION 7: ETHICAL ISSUES IN HEALTH CARE POLICY25. Patrick M. McCarthy, MD,, Richard D. Lamm, LLB, CPA, Robert M. Sade, MD: Medical Ethics Collides With Public Policy: LVAD for a Patient With Leukemia26. Brahmajee K. Nallamothu, MD, MPH, Kim A. Eagle, MD, Victor A. Ferraris, MD, PhD, Robert M. Sade, MD: Should Coronary Artery Bypass Grafting Be Regionalized?27. Carolyn Dresler, MD, MPA, Mark J. Cherry, PhD, Robert M. Sade, MD: A Clash of Rights: Should Smoking Tobacco Products in Public Places be Legally Banned?28. James W. Jones, MD, PhD. MHA, William M. Novick, MD, Robert M. Sade, MD: Should a Medical Center Deny Employment to a Physician Because He Smokes Tobacco Products?