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Chapter 6 - Ethical considerations in the surgical patient

from Section 1 - General

Published online by Cambridge University Press:  05 September 2013

By
Carl C. Hug  and
Kathleen Kinlaw
Edited by
Michael F. Lubin ,
Thomas F. Dodson  and
Neil H. Winawer
Michael F. Lubin
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Neil H. Winawer
Affiliation:
Emory University, Atlanta
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Summary

In the long tradition of medical ethics, many theories and frameworks for ethical analysis of issues and situations have been developed. The use of primary principles [1] is one such framework that has been identified as relevant for making clinical decisions:

  1. Beneficence - promoting good; acting in the best interests of the patient.

  2. Non-maleficence - avoiding or minimizing harm by action or omission.

  3. Autonomy - respecting patients’ rights to make decisions about their healthcare.

  4. - serves as the foundation for informed consent and informed refusal of diagnostic and therapeutic interventions.

  5. Justice - fair and equitable treatment that reflects what the patient is due.

These principles can be instrumental in the ethical analysis of clinical situations in which the best option for patient care is not clear. Each is considered “prima facie,” a principle that is to be honored unless it is in conflict with an equal or greater principle, in which case, the relative weight of each principle will have to be decided. For example, determining whether aggressive interventions and continuing life-supporting measures are in the best interest of the patient will have to be weighed against the suffering that it engenders and the patient's autonomous expression of their wishes to avoid certain procedures and outcomes. In the USA, high priority has traditionally been placed on patient autonomy in healthcare decisions. Many of the ethical issues covered in this chapter will explore the emphasis on patient autonomy.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
 , pp. 46 - 60
Publisher: Cambridge University Press
Print publication year: 2013

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