ETHICS IN THE OPERATING ROOM

WHY ETHICS?  Avoid jokes and laughing loudly, in front of patients, in a language
 In medicine we deal with confidential issues (related directly to
people’s lives, history, behavior, body, health, and disease.
 Patients put their trust in medical professionals and expect high
ethical standards.
 Health providing teams are expected to know and maintain a high
level of ethical standard.
 Most ethical issues are standard.
 Some special ethical issues are related to: religion, cultures, …
 Deficiencies is practical application of known ethical standards
exist
 Ethical issues are always of concern to the public.
 Any breach of ethical standards leaves harmful effects shaking the
confidence in the system.
 Media controls the public opinion
ROLE OF HOSPITALS
 Provide the best medical treatment as well as ethical standards
 Leading hospitals and institutes should:
o Apply the highest ethical standard
o Teach them to the future generation of medical personal
ETHICAL ISSUES IN THE OR
1. EXPOSURE OF THE BODY
 Parts of body should not be exposed to others (governed by
religion)
 Exceptions are allowed when necessary according to a definite
need
 Exposure of some body parts is often necessary depending on
procedure
 Examples:
o preparation for anesthesia, chest auscultation and inspection,
insertion of foley catheter
o patient’s transfer to and from: operating table, recovery, ward
o Positioning of patient, application of tourniquet, cleaning and
draping, removal of draping and tourniquet, application of cast
 Whenever exposure is necessary, it should be:
o limited to part needed only
o In the presence of limited number of people
o for the shortest period of time
not know to them, before anesthesia, during procedure with
local/spinal anesthesia
 Avoid comments and remarks on patient’s: disease, body shape or
weight, behavior that would not be said if patient is awake
 Avoid examining patients in the receiving area or in the corridors.
Examination should be done in the OR (if needed) and should
have limited exposure.
6. HONESTY
 Patients often ask who performed the surgery
 Answers should be honest and concentrate on:
o Concept of teamwork
o Quality assurance
o Supervised by the consultant/senior staff
o Teaching/training does not reduce standards
 Tell the truth:
o What went wrong
o Complications
o Unexpected incidence
7. CONSENT
 Should not be taken in the OR
 Always secure consent prior to procedures
CONCLUSIONS AND SUGGESTIONS
 Ethical issues are sensitive and important
 Ethical standards according to religion and culture must be met
 Deficiencies exist in the application of some ethical standards
 Need to revise policy of patient’s dress and the ladies dress in
order to meet local ethical standards
 Preserve patient’s dignity during all phase of transportation
 The consultant surgeon is responsible to ensure all medical staff
are aware of and follow the ethical guides
 The nurse in charge or every OR have the authority to limit the
number of personnel in the OR during preparation and surgery
especially for female patients

2. DRESS (suggested patient’s dres)

 Should provide adequate cover according to local standards
 Should provide adequate local (selective) exposure
 Should allow quick and practical wide exposure in emergency
situations
 Should look descent

3. PEOPLE GATHERING AND TRAFFIC

 Often too many people in the corridors, receiving area, and OR 
causes inconvenience to patients and staff
 Should only allow those people whose presence is absolutely
necessary
 Problem related to:
o Behavior of staff and students
o Limited space

4. NOISE
 Patients coming to OR are worried  need privacy, silence, and
reassurance
 Noise should be kept to minimum
 Discussion and stories should be in staff rooms only, away from
patients

5. COMMENTS AND BEHAVIOR

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