Is it ethically permissible to allow untrained practitioners to perform IONM? An African perspective

Area of Science:

• Medical Ethics
• African Philosophy
• Healthcare Policy

Background:

• South Africa faces a critical shortage of trained intraoperative neurophysiological monitoring (IONM) professionals.
• This deficit leads to inadequate regulatory oversight and the provision of IONM services by unqualified individuals.
• The ethical implications of allowing untrained personnel to perform IONM are underexplored, particularly from an African perspective.

Purpose of the Study:

• To ethically evaluate the permissibility of allowing untrained practitioners to conduct IONM.
• To examine this issue through the lens of African moral philosophy, focusing on solidarity.

Main Methods:

• A normative ethics approach was employed.
• Philosophical analysis drawing on moral norms derived from African philosophy, including reciprocal relationships, positive obligations, and collective responsibility.

Main Results:

• Successful surgery relies on IONM practitioners demonstrating competency, honoring interdependence, and providing reliable feedback.
• Positive obligations and collective responsibility are crucial for recognizing one's role in minimizing patient suffering and achieving good outcomes.

Conclusions:

• Untrained personnel undermine the value of solidarity by lacking necessary competencies.
• Failure to uphold positive obligations, collaborate effectively, and contribute to shared goals renders IONM by untrained staff ethically unacceptable.