Highlights | Asking important questions
- The Center for Surgical Ethics at UW Medicine promotes the highest standards of ethical surgical care throughout our region.
- The center tackles a variety of dilemmas unique to surgical care.
- The center is hosting its seventh annual Surgical Ethics Conference, Aug. 1-2.
A severely injured patient who looks to be in their late 90s arrives at the emergency department at 2 a.m. Surgeons need to decide quickly whether to perform surgery, but they don’t have access to his medical records or know how to reach his family. Should they move forward with surgery?
A pregnant woman in rural Idaho wants to pursue prenatal surgery for her unborn baby with spina bifida. However, she lacks the financial means and social support to travel for surgery. What should her care team do?
National Medicare data suggest that African Americans have an increased risk of death in seven out of eight major cardiovascular and cancer procedures, even when adjusting for the severity of illness. Why is that the case, and what can we do to improve outcomes?
Surgeons here and around the nation grapple with ethical questions like these every day. Answers don’t come easily, but they are essential to providing patients with the care they want and need.
Enter: The Center for Surgical Ethics at UW Medicine, which provides surgeons with the resources, training and education to deal with these types of questions.
Framework for ethical considerations
Established in 2017, the center promotes the highest standards of ethical care in surgery at both the patient and institutional levels.
“Surgical ethics is a relatively new discipline,” says Andrew Wright, MD, co-chair of the center and a gastrointestinal surgeon at UW Medical Center. “UW Medicine has long been known as a premier center for medical ethics, and we hope to leverage our expertise in that area to benefit the surgery world.”
Wright explains that surgical ethics has three focus areas:
- The need to make decisions quickly when patients are critically ill or injured and may need surgery
- The need to decide when it is appropriate to use innovative, novel technology in surgery
- The need for research to address disparities in surgical care centered around race, sexual orientation and other factors
These areas guide the questions and conversations the center engages in to elevate the ethical delivery of surgical care and promote education and scholarship.
Giving patients a voice
The center’s long-term vision is to be a resource for regional providers and a national leader in surgical ethics.
“The overarching goal of our program is for patients to be at the center of ethical decision-making, especially when there are gray areas, or we aren’t sure what the patient wants. Pursuing this goal at the patient and system level will allow us to create an ethical system that provides the best care to our broad population, not just in the Seattle area but throughout the WWAMI region of Washington, Wyoming, Alaska, Montana and Idaho.”
He adds that addressing ethical issues on behalf of patients in such a large geographic area is challenging.
“Patients in different areas have unique needs,” Wright says. “For example, transferring patients to UW Medicine for high-level care complicates things ethically. If someone comes from a rural area in Montana, we must consider what health resources are available to them during their recovery — what if they don’t have access to a wound care center or nutritionist? Another example is when an unhoused person with mental illness needs surgery. How can we ensure they have the follow-up care necessary for a good outcome?”
Surgical ethics conference
Next month, the center is hosting its seventh annual Surgical Ethics Conference (Aug. 1-2) to equip participants to make competent ethical decisions in clinical situations. The hybrid event will feature live and Zoom lectures tailored to surgical specialties.
Wright anticipates an international group of attendees, including surgeons, surgical residents and fellows, anesthesiologists, surgical nurses, physician assistants, social workers and hospital administrators.
The conference introduces ethical principles, concepts and lectures on surgical ethics and offers multidisciplinary small-group discussions. Carlos Pellegrini, MD, professor emeritus, will deliver the keynote presentation on the role of trust and communication when connecting with patients and colleagues.
Tickets are available on the website and at no cost to trainees.
The event is in partnership with the Department of Bioethics and Humanities’ Summer Seminar in Healthcare Ethics, held July 29-31, 2024.
For more information about the Center for Surgical Ethics Conference, please email surgethics@uw.edu.