CC2018: Getting to "No" in Surgical Consultation: When and How to Deny a Request for Operation (E)
This session has been identified and designated as Credit to Address Regulatory Mandate for Ethics.
Decisions regarding use of surgical procedures in seriously ill patients require the highest level of surgical judgment. In some instances, the decision not to offer operative intervention may be the most valuable service a surgeon can provide. Such recommendations, however, may challenge the expectations of the patient, family, and other providers and contribute to high levels of professional moral distress and dissatisfaction. This multidisciplinary panel will discuss specific problems and offer practical solutions grounded in communication skills, professionalism, practice-based learning, and systembased care to help the practicing surgeon navigate the multiple demands associated with a recommendation against operative intervention. A question-and-answer session will allow audience members to offer their perspectives and to ask the expert panelists questions.
- Considerations and Issues That Influence Recommendations Against Operation in the Acute Care Setting
David Zonies, MD, MPH, FACS, Portland, OR
- Considerations and Issues That Influence Recommendations Against Operation in Patients with Chronic Disease
Bridget N. Fahy, MD, FACS, Albuquerque, NM
- The Ethical Considerations of Not Offering Operative Intervention
Richard I. Whyte, MD, FACS, Boston, MA
- Getting to “No”: Practical Considerations
Anne C. Mosenthal, MD, FACS, Newark, NJ
- Practicing surgeons
- Apply new knowledge and ideas to improve their surgical practice
- Adapt concepts and quality measures in support of research advancements
- Enhance the quality of patient care
(Download the full list of disclosures.)
Faculty and Disclosures
David Zonies, MD, MPH, FACS, Portland, OR - No Disclosures
Bridget N. Fahy, MD, FACS, Albuquerque, NM - No Disclosures
Richard I. Whyte, MD, FACS, Boston, MA - No Disclosures
Thomas J. Miner, MD, FACS, Providence, RI - No Disclosures
Anne C. Mosenthal, MD, FACS, Newark, NJ - No Disclosures
Program Committee and Disclosures
CHAIR: Henri R. Ford, MD, MHA, FACS, FAAP, FRCSEng(Hon), Miami, FL - No Disclosures
VICE-CHAIR: David T. Cooke, MD, FACS, Sacramento, CA - No Disclosures
David C. Borgstrom, MD, FACS, Morgantown, WV - No Disclosures
Daniel L. Dent, MD, FACS, San Antonio, TX - No Disclosures
Roger R. Dmochowski, MD, FACS, Nashville, TN - Allergen: Honoraria: Consultant
Audra A. Duncan, MD, FACS, London, ON - No Disclosures
Mariam F. Eskander, MD, Boston, MA - No Disclosures
Paula Ferrada, MD, FACS, Richmond, VA - No Disclosures
Neil H. Hyman, MD, FACS, Chicago, IL - No Disclosures
Martin S. Karpeh, Jr., MD, FACS, New York, NY - No Disclosures
Dennis H. Kraus, MD, FACS, New York, NY - No Disclosures
Kenneth W. Sharp, MD, FACS, Nashville, TN - No Disclosures
David A. Spain, MD, FACS, Stanford, CA - No Disclosures
Mary T. Hawn, MD, FACS, Stanford, CA - No Disclosures
Daniel M. Herron, MD, FACS, FASBMS, New York, NY - No Disclosures
Barbara Lee Bass, MD, FACS, FRCS(Hon), Houston, TX - No Disclosures
Quan-Yang Duh, MD, FACS, San Francisco, CA - No Disclosures
B. J. Hancock, MD, FACS, FRCSC, Winnipeg, MB - No Disclosures
Ronald V. Maier, MD, FACS, FRCSEd(Hon), Seattle, WA - No Disclosures
Valerie W. Rusch, MD, FACS, New York, NY - No Disclosures
In accordance with the ACCME Accreditation Criteria, the American College of Surgeons, as the accredited provider of this activity, must ensure that anyone in a position to control the content of the educational activity has disclosed all relevant financial relationships with any commercial interest. Therefore, it is mandatory that both the program planning committee and speakers complete disclosure forms. Members of the program committee and speakers were required to disclose all financial relationships. The ACCME defines a ‘commercial interest’ as “any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients”. It does not consider providers of clinical service directly to patients to be commercial interests. The ACCME considers “relevant” financial relationships as financial transactions (in any amount) that may create a conflict of interest and occur within the 12 months preceding the time that the individual is being asked to assume a role controlling content of the educational activity.
The ACCME also requires that ACS manage any reported conflict and eliminate the potential for bias during the session. The planning committee members and speakers were contacted and the conflicts listed below have been managed to our satisfaction. However, if you perceive a bias during a session, please advise us of the circumstances on the session evaluation form.
Please note we have advised the speakers that it is their responsibility to disclose at the start of their presentation if they will be describing the use of a device, product, or drug that is not FDA approved or the off-label use of an approved device, product, or drug or unapproved usage.
The requirement for disclosure is not intended to imply any impropriety of such relationships, but simply to identify such relationships through full disclosure, and to allow the audience to form its own judgments regarding the presentation.
Note: Residents will receive a Certificate of Completion.
- 1.50 AMA PRA Category 1 Credit™
- 1.50 Self Assessment Credit
- 1.50 Certificate of Completion