Ethics in the operating room: a systematic review

Abstract Background/Objective The act of surgery involves harming vulnerable patients with the intent that the results will improve their health and, ultimately, help the patients. Such activities will inevitably entail moral decisions, yet the ethics of surgery has only recently developed as a fiel...

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Main Authors: Kari Milch Agledahl, Reidar Pedersen
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Medical Ethics
Subjects:
Online Access:https://doi.org/10.1186/s12910-024-01128-7
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author Kari Milch Agledahl
Reidar Pedersen
author_facet Kari Milch Agledahl
Reidar Pedersen
author_sort Kari Milch Agledahl
collection DOAJ
description Abstract Background/Objective The act of surgery involves harming vulnerable patients with the intent that the results will improve their health and, ultimately, help the patients. Such activities will inevitably entail moral decisions, yet the ethics of surgery has only recently developed as a field of medical ethics. Within this field, it is striking how few accounts there are of actions within the operating room. The aim of this systematic review was to investigate how much of the scientific publications on surgical ethics focus on what take place inside the operating room and to explore the ethical issues included in the publications that focus on medical ethics in the operating room. Methods We conducted a systematic search of the Medline and Embase databases using a PICO model and the search terms “surgery”, “ethics” and “operating room”. Papers were included if they focused on doctors, entailed activities inside the operating room and contained some ethical analysis. Thematic synthesis was used for data extraction and analysis. Findings Fewer than 2% of the scientific publications on surgical ethics included activities inside the operating room. A total of 108 studies were included in the full-text analysis and reported according to the RESERVE guidelines. Eight content areas covered 2/3 of the included papers: DNR orders in the OR, overlapping surgery, donation of organs, broadcasting live surgery, video recordings in the OR, communication/teamwork, implementing new surgical technology, and denying blood to Jehovah’s Witness. Discussion/Conclusions This systematic review indicates that only a small fraction of scientific publications on the ethics of surgery focus on issues inside the operating room, accentuating the need for further research to close this gap. The ethical issues that repeatedly arose in the included papers included the meaning of patient autonomy inside the operating room, the consequences of technological advances in surgery, the balancing of legitimate interests, the dehumanising potential of the OR, and the strong notion of surgeon responsibility.
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spelling doaj-art-19edf8f2787f4270818600df4c0ad5da2025-08-20T02:50:02ZengBMCBMC Medical Ethics1472-69392024-11-0125111510.1186/s12910-024-01128-7Ethics in the operating room: a systematic reviewKari Milch Agledahl0Reidar Pedersen1Department of Surgery and Orthopaedics, Finnmark Hospital TrustCentre for Medical Ethics, Institute of Health and Society, University of OsloAbstract Background/Objective The act of surgery involves harming vulnerable patients with the intent that the results will improve their health and, ultimately, help the patients. Such activities will inevitably entail moral decisions, yet the ethics of surgery has only recently developed as a field of medical ethics. Within this field, it is striking how few accounts there are of actions within the operating room. The aim of this systematic review was to investigate how much of the scientific publications on surgical ethics focus on what take place inside the operating room and to explore the ethical issues included in the publications that focus on medical ethics in the operating room. Methods We conducted a systematic search of the Medline and Embase databases using a PICO model and the search terms “surgery”, “ethics” and “operating room”. Papers were included if they focused on doctors, entailed activities inside the operating room and contained some ethical analysis. Thematic synthesis was used for data extraction and analysis. Findings Fewer than 2% of the scientific publications on surgical ethics included activities inside the operating room. A total of 108 studies were included in the full-text analysis and reported according to the RESERVE guidelines. Eight content areas covered 2/3 of the included papers: DNR orders in the OR, overlapping surgery, donation of organs, broadcasting live surgery, video recordings in the OR, communication/teamwork, implementing new surgical technology, and denying blood to Jehovah’s Witness. Discussion/Conclusions This systematic review indicates that only a small fraction of scientific publications on the ethics of surgery focus on issues inside the operating room, accentuating the need for further research to close this gap. The ethical issues that repeatedly arose in the included papers included the meaning of patient autonomy inside the operating room, the consequences of technological advances in surgery, the balancing of legitimate interests, the dehumanising potential of the OR, and the strong notion of surgeon responsibility.https://doi.org/10.1186/s12910-024-01128-7Medical ethicsClinical ethicsSurgeryOperating roomSurgical ethicsSystematic review
spellingShingle Kari Milch Agledahl
Reidar Pedersen
Ethics in the operating room: a systematic review
BMC Medical Ethics
Medical ethics
Clinical ethics
Surgery
Operating room
Surgical ethics
Systematic review
title Ethics in the operating room: a systematic review
title_full Ethics in the operating room: a systematic review
title_fullStr Ethics in the operating room: a systematic review
title_full_unstemmed Ethics in the operating room: a systematic review
title_short Ethics in the operating room: a systematic review
title_sort ethics in the operating room a systematic review
topic Medical ethics
Clinical ethics
Surgery
Operating room
Surgical ethics
Systematic review
url https://doi.org/10.1186/s12910-024-01128-7
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