Abstract
Despite our recent attention to ethical issues in orthopedics, we are still faced with multiple conflicts of interest that continue to pose ethical dilemmas to the practicing physician. Using four case scenarios, we review the potential conflicts of interest and the dilemmas posed by these frequently encountered situations. The ethical conflicts confronted in resident training, the introduction of new technology, physician advertising, and the obligations of the sports team physician are reviewed and discussed. The basic principles of medical ethics, including acting for the good of the patients and doing no harm, are discussed in the context of the four case scenarios.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Capozzi, J, Rhodes, R, Springfield, D. Ethical considerations in orthopaedic surgery. In American Academy of Orthopaedic Surgeons Instructional Course Lectures. 2000;49: 633–648.
Medical professionalism in the new millennium: a physician charter. American Academy of Orthopaedic Surgeons. Guide to professionalism and ethics in the practice of orthopaedic surgery. 2010; 8–10.
Principles of medical ethics and professionalism in orthopaedic surgery. American Academy of Orthopaedic Surgeons. Guide to professionalism and ethics in the practice of orthopaedic surgery. 2010; 1.
Code of medical ethics and professionalism for orthopaedic surgeons. American Academy of Orthopaedic Surgeons. Guide to professionalism and ethics in the practice of orthopaedic surgery. 2010; 3–7.
Capozzi J, Rhodes R. Ethics in practice: residency training. J Bone Joint Surg Am. 2000;82A:1356–7.
Lopez G, Tornetta P, Mazzocca AD, Stern PJ, Heckmann N, Gupta R. How do you educate someone to have the skills of an orthopaedic surgeon? Instructional course lectures. Am Acad Orthop Surg. 2014;63:487–94. The challenges of educating today’s residents with our current limited duty-hours and medico legal climate are discussed and potential solutions are proposed.
Edelstein A, Lovecchio F, Sujata S, Hsu W, Kim J. Impact of resident involvement on orthopaedic surgery outcomes: an analysis of 30628 patients from the American College of Surgeons National Surgical Quality Improvement program database. J Bone Joint Surg Am. 2014;96:e131. NSQIP data is reviewed to assess the impact of orthopaedic resident participation on the outcomes of surgical procedures.
Callahan J, Crowninshield R, Greenwald AS, Lieberman J, Rosenberg A, Lewallen D. American orthopaedic association symposium: introducing technology in orthopaedic practice. J Bone Joint Surg Am. 2005;87A:1146–58.
American Academy of Orthopaedic Surgeons position statement: training for new technologies. American Academy of Orthopaedic Surgeons. Guide to professionalism and ethics in the practice of orthopaedic surgery. 2010; 35–36.
Iserson KV, Chiasson PM. The ethics of applying new medical technologies. Semin Laparosc Surg. 2002;9(4):222–9.
Anand R, Graves S, DeSteiger R, Davidson D, Ryan P, Miller L, et al. What is the benefit of introducing a new hip and knee prosthesis? J Bone Joint Surg Am. 2011;93(suppl):51–4.
Peltola M, Malmivaara A, Paavola M. Learning curve for new technology. J Bone Joint Surg Am. 2013;95(23):2097–103. The learning curve associated with ten knee implant models is reviewed to determine the effects on early revision risk.
Capozzi J, Rhodes R. Ethics in practice: examining the ethical implications of an orthopaedic joint registry. J Bone Joint Surg Am. 2010;92(5):1330–3.
Capozzi J. Ethics in practice: physician advertising: evaluation of a sample advertisement. J Bone Joint Surg Am. 2007;89:2089–91.
American Academy of Orthopaedic Surgeons standards of professionalism: advertising by orthopaedic surgeons. American Academy of Orthopaedic Surgeons. Guide to professionalism and ethics in the practice of orthopaedic surgery. 2010;11–13.
Opinions on ethics and professionalism: advertising by orthopaedic surgeons. American Academy of Orthopaedic Surgeons. Guide to professionalism and ethics in the practice of orthopaedic surgery. 2010;15–20.
Krajca-Radcliffe J, Cummings N. Sideline ethical dilemmas. J Bone Joint Surg Am. 2014;96(15):e132. The multiple ethical dilemmas that face the sideline team physician are explored.
Ross J, Capozzi J, Matava M. Discussing treatment options with a minor: the conflicts related to autonomy, beneficence and paternalism. J Bone Joint Surg Am. 2012;94(1):e3. The multiple ethical dilemmas regarding the treatment of minors with sports-related injuries are explored.
Carroll, C. Ethics in practice: ethics and the American Academy of Orthopaedic Surgeons. J Bone Joint Surg Am. 2013; 95:e167 (1–3). Reviews the AAOS’ leadership role in developing policy and educational material regarding medical ethics.
Compliance with Ethics Guidelines
Conflict of Interest
Dr. James D. Capozzi and Dr. Rosamond Rhodes declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Ethics
Rights and permissions
About this article
Cite this article
Capozzi, J.D., Rhodes, R. Ethical challenges in orthopedic surgery. Curr Rev Musculoskelet Med 8, 139–144 (2015). https://doi.org/10.1007/s12178-015-9274-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12178-015-9274-y