ETHIS CASE PRESENTATION 2C, Group-4.pptx

Ethics case discussion

1. CASE PRESENTATION BY SGD-4 TO:- Dr. Lorna Sitoy

2. Group members KODURI VIGNESH-2201145 Identification of main issues Visita nuestros proyectos: FREEPIK | FLATICON | STORYSET | WEPIK | VIDEVO 2. GANDLA KALASAMUDRUM, SUMANTHRAJ-2200781 Literature research and review 3. JAYARAMAN GOPI-2200993 Analysis of the key issues. 4. PANDYA KANAN HITENDRAKUMAR- 2200431 Alternative solutions and options . 5. KUMBALA PRABHU CHARAN- 2201030 Identification of the main issues and/or problems 6. SASAPU VENKATESH-2201205 Literature research and review 7. ADAIKALASAMY JACKDOSSAN- 2200933 Identification of main issues 8. SHANMUGA RAJ SAM JOSHIPURSE- 2200678 Alternative solutions and options 9. BABU BHAVADHARANI- 2200658 Observations and/or recommendations on effective solutions . 10. MOHAMED NIZAM MOHAMED SAHIL AKTHAR-2200624 Helped to gather information

3. Dr. C, a newly appointed anesthetist in a city hospital, in alarmed by the behavior of the senior surgeon in the operating room. The surgeon uses out-of-date techniques that prolong operations and result in greater post-operative pain and longer recovery times. Moreover, he makes frequent crude jokes about the patients that obviously bother the assisting nurses. As a more junior staff member. Dr. C is reluctant to criticize the surgeon personally or to report him to higher authorities. However, he feels that he must do something to improve the situation. Case Study:-

4. 01. Lack of Formal Cooperation with Patient and Colleague’s Metodología 02. Lack of Respect for Patient's Dignity 03. Conclusiones Lack of Emotional Accountability Identification of the main issues and/or problems Surgeon's Unethical Behavior towards Patient . Dr. C is hesitant to criticize the surgeon personally or report him to higher authorities Using Outdated surgical techniques 04. 06. 05.

5. Healthcare organizations need to make explicit the types of behavior considered acceptable and those that are disruptive. The most effective way of doing this is to develop a written code of conduct for all staff and to develop policies and processes for managing disruptive behavior when it occurs. This should ensure that all staff understand what is considered disruptive. Codes are not just about preventing disruptive behavior. The purpose of a code is to establish the expectations of the institution and its community in the whole realm of personal interactions.( Leape et al..2012) Literature research & review

6. Failing to address unprofessional behavior simply promotes more of it. Besides being the right thing to do, addressing unprofessional behavior can yield improved staff satisfaction and retention, enhanced reputation, professionals who model the curriculum as taught, improved patient safety and risk-management experience, and better, more productive work environments. The most effective surveillance tools for detecting unprofessional behavior are the eyes and ears of patients, visitors, and health care team members.(Hickson et al..2007) Literature research & review

7. At its most extreme, such behavior can destabilize patient care in a variety of ways. It is this problem which makes such behavior untenable in the professional environment. The response to the complaint must be titrated to the nature of the incident and the physician’s history with the institution. Intolerance of unprofessional behavior does not mean that punitive action is required. It does mean that some action is required.(College of Physicians and Surgeons of Ontario and Ontario Hospital Association 2008) Literature research & review

8. Lack of Professionalism One of the key issues in this scenario is the senior surgeon's use of out-of-date techniques during operations. These outdated techniques can lead to prolonged operations, increased post-operative pain, and longer recovery times for patients. Analysis of the key issues Surgeon's Un Ethical Behavior Another significant issue is the senior surgeon's lack of professionalism in the operating room. Making frequent crude jokes about patients not only reflects a lack of empathy and respect for their dignity but also creates an uncomfortable and unprofessional working environment for the assisting nurses.

9. Reluctance to Criticize or Report: Dr. C, being a newly appointed anesthetist and a more junior staff member, feels hesitant to personally criticize or report the senior surgeon's behavior. This reluctance may stem from concerns about potential repercussions or strained relationships within the hospital hierarchy Lack of Respect for Patient's Dignity Senior surgeon’s poor professionalism and crude jokes about patient not only demonstrate a lack of empathy but also disrespect the patients' dignity by objectifying and demeaning the patient.

10. The surgeon's behavior towards the patient is unethical because it violates the following ethical principles: Respect for patient autonomy Beneficence Non-maleficence Justice Surgeon’s Unethical Behavior towards Patient

11. Alternative solutions and/or options Alternative 2: Seek Guidance from a Mentor or Supervisor Dr. C can approach a more experienced colleague or supervisor to seek advice on how to address the situation without directly confronting the surgeon. Alternative 1: Private Conversation with the Surgeon Dr. C could have a discreet, respectful conversation with the senior surgeon about their concerns regarding outdated techniques and inappropriate behavior. Alternative 3: Document Incidents: Keep a record of unprofessional incidents, including dates, times, and descriptions. This documentation can be useful if further action is necessary

12. Neptuno está muy lejos de la tierra The senior surgeon’s outdated techniques prolong operations and result in greater post-operative pain and longer recovery times. Recommendations: Provide the surgeon with access to relevant medical literature. This will help them stay up-to-date on the latest advances in surgery. Create a culture of safety and innovation within the hospital. This will encourage all surgeons to adopt new techniques that can improve patient care. Observations and/or recommendations on effective solutions

13. Observations and/or recommendations on effective solutions The surgeon’s frequent crude jokes about patients bother the assisting nurses. Observation Anonymous Reporting: If the behavior persists or worsens, and Dr. C feels uncomfortable confronting the surgeon directly, they may need to consider reporting the concerns anonymously to the hospital's administration or the appropriate medical board. Promotion of a respectful culture: Foster a culture of respect and professionalism by promoting positive behavior and addressing any instances of disrespectful conduct promptly. This can be achieved through regular educational initiatives, team-building exercises, and open communication channels. Recommendations:

14. The newly appointed anesthetist, Dr. C, is reluctant to criticize the surgeon or report him to higher authorities Recommendations Consider involving a neutral third party, such as a mediator or senior staff member, to facilitate discussions between the anesthetist and surgeon regarding any concerns. This can help resolve conflicts and improve working relationships. Establish an evaluation program to assess the performance and behavior of all medical staff, including the surgeon. Regular reviews can help identify recurring problems and provide opportunities for improvement or disciplinary actions if necessary. Observations and/or recommendations on effective solutions

15. Lack of Formal Cooperation with Patient and Colleagues Recommendations Be respectful and professional. Even if the surgeon or nurses are not being respectful to you, it is important to maintain your own professionalism. Continuous Collaborative meetings : Implement meetings to improve good rapport and teamwork skills for both physicians and colleagues. Observations and/or recommendations on effective solutions Observation 04.

16. Managing disruptive behaviors in surgery - Royal College of Surgeons https://www.rcseng.ac.uk/standards-and-research/standards-and-guidance/good-practice-guides/managing-disruptive-behaviours/ Code of Ethics for Nurses With Interpretive Statements https://www.princetonhcs.org/-/media/princeton/documentrepository/documentrepository/nurses/code-of-ethics.pdf identifying, measuring, and addressing unprofessional behaviors - PubMed https://pubmed.ncbi.nlm.nih.gov/17971689/ Jaffe, T. A., Hasday , S. J., Knol, M., Pradarelli , J., Pavuluri Quamme , S. R., Greenberg, C. C., & Dimick , J. B. (2018). Strategies for New Skill Acquisition by Practicing Surgeons. Journal of Surgical Education, 75(4), 928–934 Dabekaussen , K. F. A. A., Scheepers, R. A., Heineman, E., Haber, A. L., Lombarts , K. M. J. M. H., Jaarsma , D. A. D. C., & Shapiro, J. (2023). Health care professionals’ perceptions of unprofessional behaviour in the clinical workplace. PLOS ONE, 18(1), e0280444. REFERENCES

17. Wherever the art of medicine is loved, there is also a love of humanity. "Hippocrates "