Ethics in Plastic Surgery: Applying the Four Common Principles to Practice-Ethics in Plastic Surgery: Applying the Four Common Principles to Practice

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The document addresses the ethical challenges in the field of plastic surgery, highlighting the scarcity of literature dedicated to this topic even two decades after C. M. Ward's important essays on medical ethics. Ward emphasized the patient's authority in medical decisions and urged plastic surgeons to critically reflect on their decision-making processes. A systematic review mentioned in the document found that discussions on ethical principles are limited in plastic surgery literature, possibly due to a lack of understanding of ethical concepts, varying priorities within the subspecialty, and discomfort with qualitative disciplines.<br /><br />The article suggests utilizing the four principles of biomedical ethics—respect for autonomy, beneficence, nonmaleficence, and justice—as outlined by ethicists Beauchamp and Childress, to systematically address ethical dilemmas. Autonomy involves the patient's right to make informed decisions, beneficence dictates that healthcare providers should act in the patient's best interest, nonmaleficence requires avoiding harm, and justice emphasizes fair distribution of resources.<br /><br />Several ambiguous clinical scenarios are presented to illustrate potential ethical conflicts where these principles may overlap or contradict each other. The scenarios involve dilemmas like assuming care for an unsatisfied patient from another surgeon, prioritizing financial interest in patient scheduling, handling colleague malpractice, and responding to allegations of misconduct.<br /><br />While these principles provide a foundational framework for ethical decision-making, they do not always deliver definitive solutions, particularly when principles conflict. The document concludes by encouraging plastic surgeons to be deliberate in addressing ethical challenges, using these principles as a guide. The aim is to provoke further discourse and reflection, much like Ward's original call to question and reassess ethical practices in plastic surgery.

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Author(s): Gallo, Lucas M.D.; Baxter, Charmaine M.D.; Murphy, Jessica M.Sc.; Schwartz, Lisa Ph.D.; Thoma, Achilleas M.D., M.Sc Summary: The topic of ethics in plastic surgery remains underrepresented in the literature. By applying the four principles of biomedical ethics—respect for autonomy, beneficence, nonmaleficence, and justice—as described by Beauchamp and Childress to proposed ethical scenarios, this article attempts to provide plastic surgeons with a systematic approach to recognize and address ethical dilemmas as they present in day-to-day practice. Through the perspective of an experienced plastic surgeon and medical ethicist, this article is intended to spark discussion, reflection, and debate on ethical challenges in plastic surgery. Plastic and Reconstructive Surgery: September 2018 - Volume 142 - Issue 3 - p 813-818 doi: 10.1097/PRS.0000000000004674

Keywords

Lucas Gallo MD; Charmaine Baxter MD; Jessica Murphy MSc; Lisa Schwartz PhD; Achilleas Thoma MD MSc; Memben

ethical challenges

plastic surgery

C. M. Ward

medical ethics

patient autonomy

biomedical ethics

Beauchamp and Childress

ethical dilemmas

clinical scenarios

ethical decision-making