[Ethical decisions in surgery. Foundations for a principle-oriented case discussion].

Area of Science:

• Biomedical ethics
• Surgical care ethics
• Clinical decision-making

Context:

• Advanced medical interventions present complex ethical challenges in patient care.
• Societal beliefs and economic pressures further complicate ethical decision-making in surgery.
• Healthcare personnel require structured approaches to address ethical dilemmas.

Purpose:

• To present a structured, principle-based model for ethical case evaluation in surgery.
• To provide a step-wise method for addressing difficult ethical decisions in patient care.
• To guide healthcare professionals in navigating ethical challenges using biomedical ethics principles.

Summary:

• A five-step model for ethical case discussions is proposed, based on the four principles of biomedical ethics: beneficence, nonmaleficence, respect for autonomy, and justice.
• The model involves medical analysis, patient-centered ethical obligations, consideration of third-party obligations, synthesis of evaluations, and critical review.
• This structured approach aids in balancing conflicting obligations and making well-founded ethical decisions in surgical cases.

Impact:

• Facilitates structured ethical case discussions involving multidisciplinary teams.
• Supports healthcare professionals in making well-founded ethical decisions in complex surgical scenarios.
• Enhances ethical care by systematically addressing patient and third-party obligations.