An Ethical Perspective on Surgery, Cedars-Sinai Discoveries
What happens when a nurse and a social worker believe an operation scheduled for an elderly patient is not in the patient’s best interest? What if a living donor is unaware of the risks involved in a transplant? What should the medical team do if a son insists on an operation for his mother but her advance directive says no extraordinary measures?
At Cedars-Sinai, assistance is only a phone call away. The Center for Healthcare Ethics, via its Clinical Ethics Consultation Service, tackles such real-life situations on a daily basis. Working with physicians, nurses, patients, families, and others directly involved in patient care decision making, the CECS’s primary aim is three fold: identify the relevant issues; help clarify and articulate the values associated with those issues and with the various options under consideration; and facilitate decision making in a manner that respects the beliefs, commitments, and values of the primary decision makers. Far from dictating what is or is not acceptable, clinical ethics consultants foster communication and understanding, thereby helping patients, families, and care providers alike to come to a decision that is ethically acceptable and in the best interest of the patient.
Breathing New Life into Lung Surgery, Cedars-Sinai Discoveries
To observe a 30-minute “wedge resection” on a middle-aged woman with Robert McKenna, MD and his team is to watch a wonder of surgical efficiency. In the operating room the lights are dimmed, everyone is covered from head to toe in green scrubs, and music is playing on someone’s iPod. But there is very little blood and, strangest of all, no one is looking down at the patient, whose draped body is barely visible. Instead, all eyes are up, staring at three large color television screens, focusing on the movement of their instruments inserted through three small incisions in the patient’s chest. One is for a tiny video camera used to project magnified pictures of the chest cavity onto a screen, one for an instrument to hold the lung, and one for a “stapler” which removes the lung on both sides so there is no bleeding or air leakage. The patient goes home by the next day.