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Lynn M. Peterson, MD

Arch Surg. 2000;135:46-50.

Viewing ethics in surgical practice as applying critical thinking to issues of human values leads to 4 levels of consideration: the individual patient, the surgeon, surgical research and education, and surgical organizations. This perspective starts with quantitative and qualitative feedback from patients, studies of the process of surgical decision making, and understanding how surgeons matter in preoperative counseling and postoperative recovery. Surgeons should become as active in research on the psychosocial aspects of surgical care as they are in research on the biological. Based on this information, surgical training should become explicit in preparing surgeons for patient-centered management of surgical care. Finally, surgical organizations can help by recognizing research in the human values domain, setting standards that recognize feedback from patients, and addressing more formally the needs of underserved populations. This approach fails to give the basis for clear answers but gives priority to more understanding of the moral dilemmas faced by patients and their surgeons.

From the Departments of Surgery and Social Medicine, Harvard Medical School, and the Ethics Service, Brigham and Women's Hospital, Boston, Mass.

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