title: [Perioperative conflicts between anaesthesiologists and surgeons: ethics and professionalism].
abstract: In the perioperative period, several potential conflicts between anaesthetists/intensive care specialists and surgeons may exist. They are detrimental to the quality of patient care and to the well-being of the teams. They are a source of medical errors and contribute to burn-out. Patients can become the victims of such conflicts, which deserve ethical reflection. Their resolution through analysis and shared solutions is necessary. This article seeks to analyse these conflicts, taking into account their specificities and constraints. In order to understand this context, it is important to consider the specificities of each group involved and the records of such situations. Several factors can prevent these conflicts, first and foremost the patients themselves and the quality of the care that is provided. Medical deontology aims mainly at preventing and resolving these conflicts. Generally speaking, the quality approach which is increasingly applied in health care institutions (involving declarations of adverse events, morbidity/mortality reviews, benchmarking, analysis and improvement of practices, etc.) also contributes to the prevention and resolution of disagreements. The teaching of communication techniques that begins with the initial training, the evaluation of team behaviours (through simulation training for example), the respect of others' constraints, particularly when it comes to learning, as well as transparency regarding conflicts of interests, are all additional elements of conflict prevention. Lastly, conflicts may at times be caused by deviant behaviours, which must be met with a clear and uncompromising collective and institutional approach. This article concludes by offering a standardised approach for conflict resolution.
authors.affiliation: Département d'anesthésie-réanimation, hôpital Estaing, CHU de Clermont-Ferrand, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. Electronic address: jebazin@chu-clermontferrand.fr.
authors.forename: J-E
authors.initials: JE
authors.lastname: Bazin
authors.affiliation: Réanimation chirurgicale polyvalente et polytraumatologique, service d'anesthésie et des réanimations chirurgicales, groupe hospitalier Henri-Mondor, 51, avenue du Maréchale-de-Lattre-de-Tassigny, 94000 Créteil, France. Electronic address: arie.attias@hmn.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Attias
authors.affiliation: Service d'anesthésie-réanimation, centre hospitalier du pays d'Aix, avenue des Tamaris, 13616 Aix-en-Provence cedex 1, France. Electronic address: hbaghdadi@ch-aix.fr.
authors.forename: H
authors.initials: H
authors.lastname: Baghdadi
authors.affiliation: Département d'anesthésie-réanimation, hôpital Central, 29, avenue Delattre-de-Tassigny, 54035 Nancy cedex, France. Electronic address: a.baumann@chu-nancy.fr.
authors.forename: A
authors.initials: A
authors.lastname: Baumann
authors.affiliation: Département d'anesthésie-réanimation, hôpital Laënnec, CHU de Nantes, boulevard Jacques-Monod, BP 1005, 44093 Nantes cedex 1, France. Electronic address: philippe.bizouarn@chu-nantes.fr.
authors.forename: P
authors.initials: P
authors.lastname: Bizouarn
authors.affiliation: Service de médecine légale et droit de la santé, faculté de médecine de Nancy et EA 7299, 54505 Nancy, France. Electronic address: frederique.claudot@univ-lorraine.fr.
authors.forename: F
authors.initials: F
authors.lastname: Claudot
authors.affiliation: Réanimation des urgences et médicale, pôle réanimation urgence samu hyperbarie, groupe hospitalier de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex, France. Electronic address: beatrice.eon@mail.ap-hm.fr.
authors.forename: B
authors.initials: B
authors.lastname: Eon
authors.affiliation: Département d'anesthésie-réanimation, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75745 Paris cedex 10, France. Electronic address: fabienne.fieux@sls.aphp.fr.
authors.forename: F
authors.initials: F
authors.lastname: Fieux
authors.affiliation: Département d'anesthésie-réanimation, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny cedex, France. Electronic address: christophe.frot@avc.aphp.fr.
authors.forename: C
authors.initials: C
authors.lastname: Frot
authors.affiliation: CNRS, centre Maurice-Halbwachs, 48, boulevard Jourdan, 75014 Paris, France. Electronic address: Caroline.GuibetLafaye@ens.fr.
authors.forename: C
authors.initials: C
authors.lastname: Guibet Lafaye
authors.affiliation: Clinique Saint-Louis, 1, rue Basset, 78300 Poissy, France. Electronic address: omuzard@gmail.com.
authors.forename: O
authors.initials: O
authors.lastname: Muzard
authors.affiliation: Département d'anesthésie-réanimation, hôpital de la Pitié-Salpétrière, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: armelle.nicolas-robin@psl.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Nicolas-Robin
authors.affiliation: Service Castel Thibault, EHPAD « Résidence de l'Abbaye », 3, impasse de l'Abbaye, 94100 Saint-Maur-des-Fossés, France. Electronic address: virginieorjubin@yahoo.fr.
authors.forename: V
authors.initials: V
authors.lastname: Orjubin
authors.affiliation: Université de Franche Comté, UFR SLHS, 25030 Besançon, France. Electronic address: motero@doctors.org.uk.
authors.forename: M
authors.initials: M
authors.lastname: Otero-Lopez
authors.affiliation: Département de philosophie, université de Poitiers, UFR SHA, 8, rue Descartes, 86022 Poitiers, France. Electronic address: cpelluchon@yahoo.fr.
authors.forename: C
authors.initials: C
authors.lastname: Pelluchon
authors.affiliation: Service des réanimations médicale et chirurgicale, CHRU Carémeau, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France. Electronic address: justinepereira13@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Pereira
authors.affiliation: Département d'anesthésie-réanimation, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75745 Paris cedex 10, France. Electronic address: France.roussin@sls.aphp.fr.
authors.forename: F
authors.initials: F
authors.lastname: Roussin
authors.affiliation: Département d'anesthésie-réanimation, CHU de Bicêtre, AP-HP, 94275 Le Kremlin-Bicêtre, France. Electronic address: bernard.vigue@bct.aphp.fr.
authors.forename: B
authors.initials: B
authors.lastname: Vigué
authors.affiliation: Pôle d'anesthésie-réanimation, CHU d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France. Electronic address: lbeydon.angers@invivo.edu.
authors.forename: L
authors.initials: L
authors.lastname: Beydon
mesh_terms: D000776:Anesthesiology / Q000941:ethics; D034462:Dissent and Disputes; D006801:Humans; D007398:Interpersonal Relations; D059035:Perioperative Period / Q000941:ethics*; D010820:Physicians / Q000941:ethics; D066231:Surgeons / Q000941:ethics
keywords: Codes of professional ethics; Conflict; Conflits interprofessionnels; Ethics; Ethique; Health care providers; Indications opératoires; Prévention; Qualité des soins; Résolution