Dealing with the Most Difficult Situations: A Point of View from a Surgical Oncologist

  • Alberto R. FerreresEmail author


Surgical decision making in the field of Surgical Oncology confronts always difficult situations. Surgeons need to be aware of the implications and consequences of the therapeutic decisions they promote. Different models of decision making are overviewed as well as the ethical issues raised.


Decision-making process Surgical oncology Surgical ethics Ethical implications 


  1. 1.
    Lamb B, Green JS, Vincent C, et al. Decision making in surgical oncology. Surg Oncol. 2011;20:163–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Glance LG, Osler TM, Neuman MD. Redesigning surgical decision making for high risk patients. N Engl J Med. 2014;370:1379–81.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Ferreres AR. Ethical debate: the ethics of non performing extended lymphadenectomy in patients with gastrointestinal cancer. World J Surg. 2013;37:1821–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Rutkow I, Gittelsohn AM, Zuidema GD. Surgical decision making: the reliability of clinical judgement. Ann Surg. 1979;190:409–17.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Bravata DM. Making medical decisions under uncertainty. Sem Med Pract. 2000;3:6–14.Google Scholar
  6. 6.
    St Martin L, Patel P, Gallinger J, et al. Teaching the slowing-down moments of operative judgement. Surg Clin North Am. 2012;92:125–35.CrossRefPubMedGoogle Scholar
  7. 7.
    Marshall JC. Surgical decision-making: integrating evidence, inference and experience. Surg Clin North Am. 2006;86:201–15.CrossRefPubMedGoogle Scholar
  8. 8.
    Barry MJ, Edgman-Levitan S. Shared-decision making—the pinnacle of patient-centered care. N Engl J Med. 2012;366:780–1.CrossRefPubMedGoogle Scholar
  9. 9.
    McCullough LB. John Gregory’s writings on medical ethics and philosophy of medicine. Dordrecht: Kluwer Academic; 1998.Google Scholar
  10. 10.
    Sivell S, Edwards A, Elwyn G, et al. Understanding surgery choices for breast cancer: how might the theory of planned behaviour and the common sense model contribute to decision support interventions? Health Expect. 2011;14 Suppl 1:6–19.CrossRefPubMedGoogle Scholar
  11. 11.
    Cristancho SM, Vanstone M, Lingard L, et al. When surgeons face intraoperative challenges: a naturalistic model of surgical decision making. Am J Surg. 2013;205:156–62.CrossRefPubMedGoogle Scholar
  12. 12.
    Flin R, Youngson G, Yule S. How do surgeons make intraoperative decisions? Qual Saf Health Care. 2007;16:235–9.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    McCullough LB, Jones JW, Brody BA. Surgical ethics. New York: Oxford University Press; 1998.Google Scholar
  14. 14.
    Jonsen AR, Siegler M, Winslade WJ. Clinical ethics: a practical approach to ethical decisions in clinical medicine. New York: McGraw Hill; 2010.Google Scholar
  15. 15.
    Kon AA. Answering the question: “doctor, if this were your child, what would you do?”. Pediatrics. 2006;118:393–400.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Buenos AiresBuenos AiresArgentina

Personalised recommendations