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向患者披露住院医师级别外科医生的培训状况和角色的伦理框架。

An Ethical Framework for Disclosing the Training Status and Roles of Resident-Level Surgeons to Patients.

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Health System, Miami, Florida.

Michael E. DeBakey Department of Surgery and Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas.

出版信息

J Surg Educ. 2024 Oct;81(10):1446-1451. doi: 10.1016/j.jsurg.2024.06.021. Epub 2024 Jul 15.

Abstract

The concept of informed consent includes disclosure of all information that a reasonable patient would need to make a well-informed decision about whether to undergo a surgical procedure. This has traditionally been defined as including diagnosis, details about the procedure, prognosis, potential risks, and alternative treatments. The operating surgeon has final say and responsibility for the case, but the actual operation may be done (under supervision) by a surgeon in training. In this paper, we discuss the ethical dimensions of disclosing resident involvement, reviewing considerations such as established legal and professional standards, consequences for patients and for the surgical educators responsible for preparing future generations of surgeons, and patient rights. We conclude by offering a novel ethical framework intended to serve as a guide to disclosing resident involvement as part of the overall consent process.

摘要

知情同意的概念包括披露所有合理的患者需要做出明智决策的信息,包括诊断、手术程序的详细信息、预后、潜在风险和替代治疗方案。手术医生对病例具有最终决定权和责任,但实际手术可能由受训的手术医生(在监督下)进行。在本文中,我们讨论了披露住院医师参与的伦理维度,审查了既定的法律和专业标准、对患者和负责培养未来几代外科医生的外科教育者的后果以及患者权利等问题。我们最后提出了一个新的伦理框架,旨在作为披露住院医师参与作为整体同意过程的一部分的指南。

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