This document discusses ethics in surgical practice. It begins by defining ethics as meaning character. The four basic principles of ethics discussed are autonomy, beneficence, non-maleficence, and justice. Autonomy refers to a patient's ability to make their own healthcare choices. Beneficence means that surgeons should act in the best interest of patients. Non-maleficence, or "do no harm," establishes that surgeons should avoid injuring patients. Justice relates to fairness and equality in healthcare. The document outlines several ethical issues surgeons may face, including informed consent, confidentiality, end-of-life care, and maintaining standards in surgical research.

2. what you want to become in life

4. ETHICS
DR. NAWIN KUMAR
SURGICAL

5. ETHICS ETHOS WHICH MEANS “CHARACTER”

6. ETHICS

7. ETHICS

8. ETHICS
J. ROBERT OPPENHEIMER “FATHER OF THE ATOMIC BOMB

9. ETHICS
226,000 PEOPLE, MOST OF WHOM WERE CIVILIANS

10. WE CAN’T HELP EVERYONE, BUT EVERYONE CAN HELP SOMEONE.

11. WHITE COAT CEREMONY
HIPPOCRATIC OATH

12. WHITE COAT CEREMONY
HIPPOCRATIC OATH
“prescribe regimens for the good of
my patients according to my ability and
my judgment and never do harm to anyone”

13. “Whoever comes to seek cure
must be treated like your own relatives
regardless of their social status,
family economic conditions,
appearances, ages, races,
and mental abilities.
: Simiao Sun

15. In 1847, the American Medical Association adopted its first code of ethics
Institutional guidelines for ethics in clinical teaching and surgical residency programs

16. published by the Royal College of
Surgeons, is a repository of ethical
guidance
GOOD SURGICAL PRACTICE

17. • Honesty and Integrity
• Mutual respect
• Trust
• Empathy
• Mutual goals
DOCTOR-PATIENT
RELATIONSHIP

18. Government
media
Law
Society

19. BASIC PRINCIPLES OF ETHICS
Autonomy Non maleficence Justice
Beneficence

20. AUTONOMY

21. AUTONOMY

22. AUTONOMY
ABILITY TO MAKE CHOICES

23. AUTONOMY
• Disease
• Risks and benefits of the procedure
• Likelihood of success of the procedure
• Course of disease after procedure
• Any unexpected hazards of proposed surgery
• Alternatives of the procedure
• Natural course of disease
ABILITY TO MAKE CHOICES

24. AUTONOMY
ABILITY TO MAKE CHOICES

25. AUTONOMY
AUTONOMY IS THE BASIS FOR INFORMED CONSENT

26. BENEFICIENCE
SURGEON SHOULD ACT IN “THE BEST INTEREST” OF THE PATIENT

27. BENEFICIENCE
• Surgical competence
• Functioning equipment
• optimal operating condition
• technology and equipment is functioning and reliable.
SURGEON SHOULD ACT IN “THE BEST INTEREST” OF THE PATIENT

28. NON MALEFICENCE

29. NON MALEFICENCE
DO NO HARM

30. NON MALEFICENCE

31. NON MALEFICENCE
• Limits
• when and where to stop scalpel
“ FELLOWSHIP OF KNIFE”

32. NON MALEFICENCE • Research and auditing
• “mortality and morbidity” meetings

33. NON MALEFICENCE
• An act or omission by a surgeon that deviates from accepted standards of practice in the medical
community which causes injury to the patient
MEDICAL MALPRACTICE

34. NON MALEFICENCE
MEDICAL MALPRACTICE

35. NON MALEFICENCE
• Communication
• Documentation
• Documentation of communication
• Communication of documentation
• Preservation of documentation

36. JUSTICE
FAIRNESS AND EQUALITY

37. JUSTICE
• The distribution of scarce health resources
• Fair distribution of scarce resources
• Competing needs
• Rights and obligations
• Potential conflicts with established legislations
FAIRNESS AND EQUALITY

38. ISSUES IN SURGICAL ETHICS
• Informed consent and difficulties
• Confidentiality
• End of life –Issues
• As Surgeon ethical issues in operation theatre
• Surgical research
• Excellent standards

39. ISSUES IN SURGICAL ETHICS
• Calm and Quite place.
• Patient’s language.
• take Time
• Person to take consent
• Information - accurate and reasonably complete.
• Avoid Technical language
• Translators
INFORMED CONSENT

40. ISSUES IN SURGICAL ETHICS
• Breaking confidentiality
• If the patient is a threat to self or others
• Other team members – improving
treatment options
• Public interest
• Court order
CONFIDENTIALITY

41. ISSUES IN SURGICAL ETHICS
• no evidence shows that a specific
treatment desired by the patient will
provide any benefit
• treatment must stop
• Do not resuscitate
END OF LIFE –ISSUES

42. ETHICAL ISSUES IN OPERATION THEATRE
• Protect privacy and dignity of patient
• Limited to parts needed only
• In the presence of limited number of people
• Limited time
EXPOSURE OF BODY

43. ETHICAL ISSUES IN OPERATION THEATRE
OT TRAFFIC AND NOICE
• Too many people in the corridors, receiving area and OR
• Patients coming to OR are worried → need privacy, silence and
reassurance.
• Discussions and stories should be in staff rooms only

44. ETHICAL ISSUES IN OPERATION THEATRE
COMMENTS AND BEHAVIOR

45. ETHICAL ISSUES IN OPERATION THEATRE
COMMENTS AND BEHAVIOR
• No Jokes and laughing, speaking loudly in front of patients
• In a language not known to them, before anesthesia, during procedure
with local/spinal anesthesia.
• Comments regarding disease, body shape and weight, that would not be
said if patient is awake.

46. RESEARCH
• through research ethics committees
• should not participate in research that has not been approved by
recognised bodies

47. GOOD STANDARDS
• must only offer specialised treatment in which they have been properly
trained

48. THANK YOU