Angelos Peter
MacLean Center for Clinical Medical Ethics, University of Chicago, 5841 S Maryland Ave, MC4052, Chicago, Illinois 60637 USA.
J Clin Ethics. 2019 Spring;30(1):49-55.
The practice of surgery requires consideration of a number of specific aspects of clinical medical ethics that are different from those most influential in other areas of medical care. The nature of surgical care alters the sense of responsibility that surgeons feel for their actions and also alters the relationship between surgeons and patients. Because surgical care requires patients to place such great trust in their surgeons, surgical informed consent must emphasize the importance of that trust. Surgeons must use innovative means to solve individual patient problems even if the result is a novel operation. Surgical procedures may be altered due to the unexpected findings in the operating room and therefore surgeons must have considered how to respond in such situations. The future of surgical practice will inevitably lead to increasing ethical concerns in maintaining the ethical dimension of surgery, in allowing autonomy for trainees while maintaining patients' safety, and in balancing surgical risks of prophylactic surgery with the genetic predisposition to develop cancer.
外科手术的实践需要考虑临床医疗伦理的一些特定方面，这些方面与医疗护理其他领域中最具影响力的方面有所不同。外科护理的性质改变了外科医生对其行为的责任感，也改变了外科医生与患者之间的关系。由于外科护理要求患者对外科医生给予极大的信任，手术知情同意必须强调这种信任的重要性。外科医生必须采用创新方法来解决个体患者的问题，即使结果是一种新颖的手术。由于手术室中出现意外发现，手术程序可能会改变，因此外科医生必须考虑如何应对这种情况。外科手术实践的未来将不可避免地在维护手术的伦理层面、在保障患者安全的同时给予实习医生自主权以及在平衡预防性手术的外科风险与患癌遗传易感性方面引发越来越多的伦理问题。
