The Ethics of Optimization: An Evaluation Framework for Arthroplasty Surgeons

Nicholas J Giori , Kristine Godziuk

Instructional Course Lectures +

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November 25, 2025

View abstract on PubMed

Summary

Patient optimization before surgery involves ethical considerations, particularly balancing risk reduction with access to care. A proposed framework aids surgeons in evaluating modifiable risk factors like body mass index for improved surgical outcomes.

Area Of Science

Medical Ethics
Surgical Optimization
Patient Care

Background

Patient optimization is a complex process with ethical implications.
Variability exists in defining and achieving patient optimization, leading to inconsistent outcomes.
Ethical principles (beneficence, nonmaleficence, autonomy, justice) are crucial for guiding decisions.

Purpose Of The Study

To propose a framework for evaluating potentially modifiable risk factors in patient optimization.
To guide surgeons in ethically assessing and managing patient risk before procedures.
To explore the application of this framework using body mass index in total joint arthroplasty.

Main Methods

Development of a three-question framework to assess modifiable risk factors.
Evaluation of the relationship between risk factors and complications.
Assessment of the modifiability and impact of risk factor improvement on risk reduction.

Main Results

The framework provides a structured approach to considering modifiable risk factors.
Ethical tenets offer guidance for decision-making in patient optimization.
Body mass index serves as a case study for applying the framework in total joint arthroplasty.

Conclusions

Ethical considerations are paramount in patient optimization, especially when balancing risk and access.
A systematic framework can assist surgeons in evaluating and managing patient-specific risk factors.
Further application of the framework can refine optimization strategies and improve surgical outcomes.