Ethical challenges in surgery as narrated by practicing surgeons.
BACKGROUND
The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations.


METHODS
Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation.


RESULTS
No differences in ethical reasoning between male and female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues.


CONCLUSIONS
The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity.
Torjuul
Kirsti
K
Sør-Trøndelag University College, Faculty of Nursing, Trondheim, Norway. kirsti.torjuul@hist.no.
Nordam
Ann
A
Sørlie
Venke
V
D001291:Attitude of Health Personnel; D003142:Communication; D004992:Ethics, Medical; D013502:General Surgery / Q000941:ethics*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D009664:Norway; D010348:Patient Care Team; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D014342:Truth Disclosure / Q000941:ethics; D035501:Uncertainty
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