How to Solve Ethical Conflicts in Everyday Surgical Practice: A Toolbox
In the practice of medicine and surgery, ethically challenging issues frequently arise. Surgeons practice within a medical realm that is deeply dependent upon a meaningful physician-patient relationship, with an ethos dually emphasizing patient self-determination and physician guidance. Surgeons are likely familiar with the navigation of ethical conundrums, however frequently do so without formal training. While historically the purview of theologians and philosophers, the field of clinical medical ethics has evolved significantly since its inception in the 1970s, helping clinicians to practically address commonly encountered issues. With this chapter, we aim to provide the practicing surgeon with a toolkit to assist in formulating ethical questions and addressing them in a systematic fashion. First, we present a fictional patient scenario with several ethical issues commonly encountered by surgical providers. We then introduce three well-known, published methods for the evaluation of the ethical problem – the Beauchamp and Childress model, the “Four-Topic (or Four-Box)” approach, and the Pellegrino approach – and apply each method to the theoretical case.
KeywordsSurgical ethics Clinical ethics Medical ethics Four-box model Ethical principlism
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