Our Surgeries Get Better, But Our Patients Get Worse (original) (raw)
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Ethical considerations in orthopaedic surgery
Instructional course lectures
Because our actions as physicians have far-reaching consequences, and because society allows us to do things to others that no one else is free to do, physicians' professional activities fall under the domain of ethical evaluation. We are charged with the obligation to use specialized scientific knowledge, to work in concert with others, and to act for the good of our patients. In fact, acting for the good of our patients is the central tenet of ethical medical behavior. What constitutes the good of the patient, however, is not always clear. In general, we act to limit disease, restore function, alleviate suffering, and prolong life. We understand fully, however, that these goals may conflict with one another. Judgment about what is right for a particular patient leads us to another crucial consideration of ethical behavior, namely, respect for patient autonomy. We recognize that individuals have the right to control their own destiny. Patients have a right, therefore, to make c...
PRACTICE GUIDELINES, PATIENT INTERESTS, AND RISKY PROCEDURES
1996
A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benejit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability o f risk/benejit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect f o r persons is not breached b y limiting the lreatment options offered to patients to those therapies which have a 'reasonable' risk/benejit ratio. This 'reasonableness' is context dependent, and should be properly decided those with expertise in thefield.
Quality of Health Care in Surgery
Although surgical complications have no doubt been around since the stone age, when primitive men first used pieces of sharpened flint to chisel holes in injured heads or perhaps to open painful ulcers or tumours, it was really not until the late 18 th century that those complex pathological changes which can take place inside wounds, were studied scientifically . For in the last two centuries, surgery and medicine in all of their branches have changed, both conceptually and technically, beyond recognition. Conditions which had hitherto been seen as "natural" -such as inflammation, pus, pain, haemorrhage, fever and high mortality -were increasingly perceived as essentially extraneous factors which could be eradicated from the surgical environment if not yet, at least at some stage in the not too distant future. And while post-Renaissance anatomy and the experiences gained in the treatment of gunshot wounds had made the surgeon much more confident in so far as he now knew exactly what he would encounter beneath the surface whenever he took up his knife to operate, it was really not until after 1846 that this vast treasury of accumulated body knowledge began at last to reap a sweeping therapeutic harvest in terms of new and increasingly safe operations which eventually extended into every cavity area and organ of the human body. And ironically, one might say that nowadays the range of potential surgical complications is greater than ever before; but this is only because the modern surgeon can confidently address problems within the human body which would have been unimaginable 25, 50, 100 or 200 years ago, yet by the judicious use of that vast armamentum of clinical techniques available today, he stands a very good chance of stabilizing and overcoming such complications as and when they occur.
Ethics and Decision Making in Vascular Surgery
Acta Informatica Medica, 2006
Review SUMMARY Correct decision makin is essential for good final medical outcome. During the practice, physicians are constantly forced to choose the best option for the patient. Those options somtimes has ethycal side and sometimes has practical nature. Furthermore, decision making has manz ethic roots in general practice as well as in all other medical branches including vascular surgery. All decisions has to follow the principles of mortallitz, ethics and legallitz. The moral normes are not imposed from outside by the force of the authority of law. That norms are the product of society and social consciousness and moral sence. That definition of moral is also suitable for medical opinion. Ethic principles are developed from moral principles, especialy in medicine and it is a question of medical phylosophy.
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.
Surgical safety: Are we really concerned?
ip innovative publication pvt. ltd , 2019
Patient safety is one of the most important goals for health care system. Errors in the treatment result in significant morbidity and mortality for the affected patient population. This consequently burden the health care providers and incur disproportionately high costs to health care system due to a change in the doctor - patient relationship since last few decades. Medical error is a term used when there is an unintended injury or complication that results in prolonged hospital stay, disability at the time of discharge or death, caused by healthcare management rather than the underlying disease itself. Medical errors can be categorized into Medication error, diagnostic error, surgical error, equipment failure, infection (Hospital acquired, surgical site infection, or implant related), error during Blood transfusion, order misinterpretation. 10% of in-patients suffer from adverse events and almost half of these are considered to be preventable.1,2