© Springer International Publishing AG 2018 377
T.S. Köhler, B. Schwartz (eds.), Surgeons as Educators,
https://doi.org/10.1007/978-3-319-64728-9_21
S. Ganai, MD, PhD, FACS (*)
Department of Surgery, Southern Illinois University School of Medicine,
315 W. Carpenter Street, Springfield, IL 62794-9638, USA
e-mail: [email protected]
K.M. Devon, MD, MSc, FRCSC
Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
Joint Center for Bioethics, Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
Women’s College Hospital, Toronto, ON, Canada
University Health Network, Toronto, ON, Canada
21
Teaching Surgical Ethics
Sabha Ganai and Karen M. Devon
The Problem
Surgeons deal with ethics in daily practice, whether in the process of obtaining
informed consent for a procedure, encountering a sporadic innovation in the operat-
ing room, disclosure of errors and complications, or interacting with surrogate
decision- makers. Surgeons support patients and their families at the extremes of life
and must be comfortable and competent in addressing palliative and end-of-life
care. Surgeons must also be able to adequately discuss risk as part of decision-
making and should be able to effectively identify and communicate such issues of
uncertainty with their patients. Ethical principles of importance include respect for
autonomy, nonmaleficence, beneficence, and justice, as well as professional duties
including truth-telling, respect for privacy, maintenance of competency/proficiency,
accountability, and other normative standards of appropriate behavior learned in the
surgical context [ 3 ]. An ethics education can ideally prepare surgical residents to
approach complex cases by teaching residents to clarify their values, principles,
contexts, and hone their negotiating skills as they learn to effectively listen and
communicate [ 16 , 17 ].