Tayade Motilal Chandu, Dalvi Shashank D
Assistant Professor and PhD Scholar, Department of Physiology, Rural Medical College, Pravara Institute of Medical Sciences , Loni, Tal. Rahata, District Ahmednager, India .
Vice chancellor, Pravara Institute of Medical Sciences , Loni, Tal. Rahata, District Ahmednager, India .
J Clin Diagn Res. 2016 Apr;10(4):JE01-4. doi: 10.7860/JCDR/2016/18958.7694. Epub 2016 Apr 1.
In clinical practice performing any surgical procedure is inconsistent because all surgical procedures carry definitely some degree of risk. Worldwide every year millions of patients go under knife, but many of them are enduring great pain and shelling out thousands and dollars for surgeries they don't really need. This review work was planned with an intention to focus attention towards it with reporting cited evidences of unnecessary surgical operations and discuss ethical issues concern with it. In present review the references search included standard citations Google scholar, MEDLINE and PUBMED. We also used Google search engine for screening various news concern with highlighting this topic in community and online media. For articles we go through more than 60 articles from worldwide and 12 news media views from Google search in last one year. We used following quotes for their search-unnecessary surgeries, second opinion, ethical issues in unnecessary surgeries. Geographical variations were also kept in view. Our intension was highlighting ethical issues concern with unnecessary surgical operations. Henceforth we excluded such work that does not concern with ethical issues. Unnecessary surgery is that which is medically unjustifiable when the risks and costs are more than the likely therapeutic benefits or relief to the patient based on the patient's lifestyle requirements. To avoid or minimize such interventions basic seeding of ethics in curriculum and strict laws will definitely helpful in clinical practice. In conclusion, our aim was to highlight this major issue and underline need of competency based medical bioethics education in Indian scenario.
在临床实践中，实施任何外科手术都存在不确定性，因为所有外科手术都必然存在一定程度的风险。在全球范围内，每年有数百万患者接受手术，但他们中的许多人正承受着巨大的痛苦，并且为他们并不真正需要的手术支付数千美元。开展这项综述工作的目的是通过报告所引用的不必要外科手术的证据，引起人们对这一问题的关注，并讨论与之相关的伦理问题。在本次综述中，参考文献检索包括谷歌学术、医学文献数据库（MEDLINE）和医学期刊数据库（PUBMED）等标准文献来源。我们还使用谷歌搜索引擎筛选社区和在线媒体中各种关于突出这一主题的新闻。对于文章，我们查阅了过去一年来自全球的60多篇文章以及谷歌搜索的12篇新闻媒体观点。我们使用了以下检索词——不必要的手术、二次诊断意见、不必要手术中的伦理问题。同时也考虑了地域差异。我们的目的是突出与不必要外科手术相关的伦理问题。因此，我们排除了与伦理问题无关的研究。不必要的手术是指基于患者的生活方式需求，当风险和成本超过对患者可能的治疗益处或缓解程度时，在医学上没有正当理由的手术。为了避免或尽量减少此类干预，在课程中植入基本的伦理观念以及制定严格的法律肯定有助于临床实践。总之，我们的目的是突出这个重大问题，并强调在印度背景下基于能力的医学伦理教育的必要性。
