Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts.
Augusta University at the Medical College of Georgia, Augusta.
JAMA Surg. 2022 Jun 1;157(6):532-539. doi: 10.1001/jamasurg.2022.0621.
Social determinants of health have been shown to be key drivers of disparities in access to surgical care and surgical outcomes. Though the concept of social responsibility has received growing attention in the medical field, little has been published contextualizing social responsibility in surgery. In this narrative review, we define social responsibility as it relates to surgery, explore the duty of surgeons to society, and provide examples of social factors associated with adverse surgical outcomes and how they can be mitigated.
The concept of social responsibility in surgery has deep roots in medical codes of ethics and evolved alongside changing views on human rights and the role of social factors in disease. The ethical duty of surgeons to society is based on the ethical principles of benevolence and justice and is grounded within the framework of the social contract. Surgeons have a responsibility to understand how factors such as patient demographics, the social environment, clinician awareness, and the health care system are associated with inequitable patient outcomes. Through education, we can empower surgeons to advocate for their patients, address the causes and consequences of surgical disparities, and incorporate social responsibility into their daily practice.
One of the greatest challenges in the field of surgery is ensuring that surgical care is provided in an equitable and sustainable way. Surgeons have a duty to understand the factors that lead to health care disparities and use their knowledge, skills, and privileged position to address these issues at the individual and societal level.
健康的社会决定因素已被证明是影响获得外科护理和手术结果差距的关键因素。尽管社会责任的概念在医学领域受到越来越多的关注,但很少有文献将社会责任置于外科领域进行阐述。在这篇叙述性评论中,我们定义了与外科相关的社会责任,探讨了外科医生对社会的责任,并提供了与不良手术结果相关的社会因素的实例,以及如何减轻这些因素的影响。
外科领域的社会责任概念在医学伦理准则中有着深厚的根基,并随着人权观念和社会因素在疾病中的作用的变化而演变。外科医生对社会的道德责任基于仁慈和公正的伦理原则,并基于社会契约框架。外科医生有责任了解患者人口统计学、社会环境、临床医生意识和医疗保健系统等因素如何与患者结果的不平等相关。通过教育,我们可以赋予外科医生权力,为患者发声,解决外科差异的原因和后果,并将社会责任纳入他们的日常实践中。
外科领域最大的挑战之一是确保以公平和可持续的方式提供外科护理。外科医生有责任了解导致医疗保健差异的因素,并利用他们的知识、技能和特权地位,在个人和社会层面上解决这些问题。