Skip to main content
SpringerLink
Log in

The Transformation and Challenges of the Surgeon–Patient Relationship

  • Chapter
  • First Online:
Surgical Ethics

Abstract

This chapter explores the transformation and the challenges of the surgeon–patient relationship. It reviews the historical, legal, and bioethical background of the surgical profession and its unique nature as compared to other fields of medicine. Although the foundation of the surgeon–patient relationship has always been, and still remains, the principle of beneficence, the relationship has undergone a dynamic shift that places greater value on both patient autonomy and societal justice than in previous times. The surgeon–patient relationship is complicated by a variety of conflicts of interests and obligations, as well as emerging challenges arising from advancing technology, scarce resources, and a team-based approach to healthcare. Navigating the many demands of our changing professional values may appear difficult, but ultimately a practice built on honesty with our patients, each other, and ourselves can help maintain trust in the surgeon–patient relationship.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bosk CL. What would you do? Juggling bioethics and ethnography. Chicago: University of Chicago Press; 2008.

    Google Scholar 

  2. Langerman A, Angelos P, Siegler M. The “call for help”: intraoperative consultation and the surgeon-patient relationship. J Am Coll Surg. 2014;219(6):1181–6.

    Article  Google Scholar 

  3. Axelrod DA, Goold SD. Maintaining trust in the surgeon-patient relationship: challenges for the new millennium. Arch Surg. 2000;135(1):55–61.

    Article  CAS  Google Scholar 

  4. Strebler A, Valentin C. Considering ethics, aesthetics and the dignity of the individual. Cult Med Psychiatry. 2014;38(1):35–59.

    Article  Google Scholar 

  5. Locke J. Two treatises of government. Cambridge: Cambridge University Press; 1988.

    Book  Google Scholar 

  6. Schwarze MLBC, Brasel KJ. Surgical “buy-in”: the contractual relationship between surgeons and patients that influences decisions regarding life-supporting therapy. Crit Care Med. 2010;38(3):843–8.

    Article  Google Scholar 

  7. Shah RD, Rasinski KA, Alexander GC. The influence of surrogate decision makers on clinical decision making for critically III adults. J Intensive Care Med. 2015;30(5):278–85.

    Article  Google Scholar 

  8. Tauber AI. Historical and philosophical reflections on patient autonomy. Health Care Anal. 2001;9(3):299–319.

    Article  CAS  Google Scholar 

  9. https://www.youtube.com/watch?v=ryqpYnlZMqk.

  10. Ramsey P. The patient as person: medical and legal intersections. New Haven: Yale Univeristy Press; 1970.

    Google Scholar 

  11. Hurley v Eddingfield, 156 Ind 416, 59 NE 1058 (Ind 1901).

    Google Scholar 

  12. Ricks v Budge, 91 Utah 307, 64 P2d 208 (Utah 1937).

    Google Scholar 

  13. Mead v Adler, 231 Or App 451, 220 P3d 118 (Or 2009).

    Google Scholar 

  14. Schloendorff v. Society of New York Hospital, 105 N.E. 92, 93 (N.Y. 1914).

    Google Scholar 

  15. Canterbury v. Spence (464 F.2d. 772, 782 D.C. Cir. 1972).

    Google Scholar 

  16. Blake JH, Schwemmer MK, Sade RM. The patient-surgeon relationship in the cyber era. Communication and information. Thorac Surg Clin. 2012;22(4):531–8.

    Article  Google Scholar 

  17. Plato: Meno.

    Google Scholar 

  18. Wilks T. Social work and narrative ethics. Br J Soc Work. 35(8):1249–64.

    Google Scholar 

  19. Donchin A, Scully J. Feminist Bioethics, The Stanford Encyclopedia of Philosophy (Winter 2015 Edition), Edward N. Zalta (ed.), https://plato.stanford.edu/entries/feminist-bioethics/.

  20. Haidt J. The righteous mind: why good people are divided by politics and religion. New York: Pantheon; 2012.

    Google Scholar 

  21. Annas GJ, Grodin MA. The Nazi doctors and the Nuremberg code. Human rights in human experimentation. Oxford: Oxford University Press; 1992.

    Google Scholar 

  22. Beauchamp TL, Childress JF. Principles of bioethics. 4th ed. Oxford/New York: Oxford University Press; 1994.

    Google Scholar 

  23. Kant I. The metaphysics of morals. New York: Cambridge University Press; 1996.

    Book  Google Scholar 

  24. Dostoevsky F. The brothers Karmazov. San Francisco: North Point Press; 1990.

    Google Scholar 

  25. Gaylin W, Jennings B. The perversion of autonomy: the proper use of coercion and constraints in a liberal society. New York: Free Press; 1996.

    Google Scholar 

  26. Gilbar R. Family involvement, independence, and patient autonomy in practice. Med Law Rev. 2011;19(2):192–234.

    Article  Google Scholar 

  27. Dworkin G. The theory and practice of autonomy. Cambridge: Cambridge University Press; 1988.

    Book  Google Scholar 

  28. Rawls J. A theory of justice. Cambridge: The Belknap Press of Harvard University Press; 1971.

    Google Scholar 

  29. Angell M. The doctor as double agent. Kennedy Inst Ethics J. 1993;3(3):279–86.

    Article  CAS  Google Scholar 

  30. Tilburt JC. Addressing dual agency: getting specific about the expectations of professionalism. Am J Bioeth. 2014;14(9):29–36.

    Article  Google Scholar 

  31. Frey JJ 3rd. Writing an excuse or educating the patient. Virtual Mentor. 2012;14(1):13–6.

    Article  Google Scholar 

  32. Morreim EH. Fiscal scarcity and the inevitability of bedside budget balancing. Arch Intern Med. 1989;149(5):1012–5.

    Article  CAS  Google Scholar 

  33. Kavarana MN, Sade RM. Ethical issues in cardiac surgery. Futur Cardiol. 2012;8(3):451–65.

    Article  CAS  Google Scholar 

  34. Morrell ED, Brown BP, Qi R, Drabiak K, Helft PR. The do-not-resuscitate order: associations with advance directives, physician specialty and documentation of discussion 15 years after the Patient Self-Determination Act. J Med Ethics. 2008;34(9):642–7.

    Article  CAS  Google Scholar 

  35. Wade NJ, Diana D. Binaural hearing—before and after the stethophone. Acoustics Today. 2008;4(3)

    Google Scholar 

  36. Kennedy M. Let me die in your house: cardiac distress and sympathy in nineteenth-century british medicine. Lit Med. 2014;32(1):105–32.

    Article  Google Scholar 

  37. Wilk AS, Platt JE. Measuring physicians’ trust: a scoping review with implications for public policy. Soc Sci Med. 2016;165:1–7.

    Article  Google Scholar 

  38. Persad G, Wertheimer A, Emanuel EJ. Principles for allocation of scarce medical interventions. Lancet. 2009;373(9661):423–31.

    Article  Google Scholar 

  39. Skinner S. Patient-centered care model in IONM: a review and commentary. J Clin Neurophysiol. 2013;30(2):204–9.

    Article  Google Scholar 

  40. Pellegrini C. Trust: the keystone of the physician-patient relationship. Bull Am Coll Surg. 2017;102(1):58–61.

    PubMed  Google Scholar 

  41. D’Amico TA, McKneally MF, Sade RM. Ethics in cardiothoracic surgery: a survey of surgeons’ views. Ann Thorac Surg. 2010;90(1):11–13.e1–4.

    Article  Google Scholar 

  42. Helft PR, Eckles RE, Torbeck L. Ethics education in surgical residency programs: a review of the literature. J Surg Educ. 2009;66(1):35–42.

    Article  Google Scholar 

  43. Snelgrove R, Ng S, Devon K. Ethics M&Ms: towards a recognition of ethics in everyday practice. J Grad Med Educ. 2016; 8(3):462–4.

    Google Scholar 

Suggested Readings

  1. Blake V. When is a patient-physician relationship established? Virtual Mentor. 2012;14(5):403–6.

    Article  Google Scholar 

  2. Daniels N. Accountability for reasonableness. BMJ. 2000;321(7272):1300–1.

    Article  CAS  Google Scholar 

  3. Putman MS, Yoon JD, Rasinski KA, Curlin FA. Directive counsel and morally controversial medical decision-making: findings from two national surveys of primary care physicians. J Gen Intern Med. 2014;29(2):335–40.

    Article  Google Scholar 

  4. Bernat JL, Peterson LM. Patient-centered informed consent in surgical practice. Arch Surg. 2006;141(1):86–92.

    Article  Google Scholar 

  5. Burkle CM, Mueller PS, Swetz KM, Hook CC, Keegan MT. Physician perspectives and compliance with patient advance directives: the role external factors play on physician decision making. BMC Med Ethics. 2012;13:31.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Surgical Critical Care, Acute Care and Trauma Surgery, Yale School of Medicine, New Haven, CT, USA

    Piroska K. Kopar

Authors
  1. Piroska K. Kopar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Piroska K. Kopar .

Editor information

Editors and Affiliations

  1. Department of Surgery, University of Buenos Aires, Buenos Aires, Argentina

    Alberto R. Ferreres

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kopar, P.K. (2019). The Transformation and Challenges of the Surgeon–Patient Relationship. In: Ferreres, A. (eds) Surgical Ethics. Springer, Cham. https://doi.org/10.1007/978-3-030-05964-4_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-05964-4_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05963-7

  • Online ISBN: 978-3-030-05964-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation