The choices we make: Ethical challenges in trauma surgery

Area of Science:

• Medical Ethics
• Surgical Practice
• Trauma Care

Background:

• Ethical issues are common in trauma surgery but understudied.
• Trauma surgeons face unique ethical dilemmas in clinical practice.

Purpose of the Study:

• Characterize ethical dilemmas encountered by trauma surgeons.
• Describe perceptions of managing these dilemmas and strategies used.

Main Methods:

• Electronic survey of U.S. trauma society members on ethical scenarios.
• Survey instrument developed using literature and cognitive interviews.
• Categorized ethical problems and analyzed self-efficacy in management.

Main Results:

• Most common ethical categories: general ethics and communication (79%).
• Least frequent ethical issues: conflict (21%).
• Lowest self-efficacy reported for autonomy issues; higher self-efficacy linked to experience and frequent ethical challenges.

Conclusions:

• Trauma surgeons regularly encounter ethical challenges, especially communication-related.
• Lowest self-efficacy in managing autonomy issues; experience correlates with higher self-efficacy.
• Future research should explore self-efficacy translation to behavior and skill enhancement.