Action ethical dilemmas in surgery: an interview study of practicing surgeons.
BACKGROUND
The aim of this study was to describe the kinds of ethical dilemmas surgeons face during practice.


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 physicians and nurses about ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation.


RESULTS
No gender differences were found in the kinds of ethical dilemmas identified among male and female surgeons. The main finding was that surgeons experienced ethical dilemmas in deciding the right treatment in different situations. The dilemmas included starting or withholding treatment, continuing or withdrawing treatment, overtreatment, respecting the patients and meeting patients' expectations. The main focus in the narratives was on ethical dilemmas concerning the patients' well-being, treatment and care. The surgeons narrated about whether they should act according to their own convictions or according to the opinions of principal colleagues or colleagues from other departments. Handling incompetent colleagues was also seen as an ethical dilemma. Prioritization of limited resources and following social laws and regulations represented ethical dilemmas when they contradicted what the surgeons considered was in the patients' best interests.


CONCLUSIONS
The surgeons seemed confident in their professional role although the many ethical dilemmas they experienced in trying to meet the expectations of patients, colleagues and society also made them professionally and personally vulnerable.
Sør-Trøndelag University College, Faculty of Nursing, Trondheim, Norway. kirsti.torjuul@hist.no.
Kirsti
K
Torjuul
Ann
A
Nordam
Venke
V
Sørlie
D001291:Attitude of Health Personnel; D026690:Ethics, Clinical; D013502:General Surgery / Q000941:ethics*; D015276:Health Care Rationing / Q000941:ethics; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D007400:Interprofessional Relations; D007407:Interviews as Topic; D033262:Narration; D009664:Norway; D010815:Physician Impairment; D010817:Physician-Patient Relations / Q000941:ethics; D010820:Physicians / Q000941:ethics* / Q000523:psychology*; D016414:Resuscitation Orders / Q000331:legislation & jurisprudence; D014850:Waiting Lists; D028761:Withholding Treatment / Q000941:ethics