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Patients with acute critical illness often require emergency surgery. In these situations, the risks of surgery are high, whereas the benefits of surgery may be marginal or debatable. This places the surgeon and the patient (or their surrogate decision-maker) in a complex situation, where the ethics regarding the “right” decision are not clear and decisions regarding treatment must be made expeditiously. This chapter explores the issues involved in the decision-making process for a severely ill patient with an acute surgical condition through the use of both personal vignette and literature review. The chapter concludes by focusing on shared decision-making and how this technique remedies many of the ethical concerns facing both surgeons and patients during these complex, challenging clinical situations.

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Operating on the Critically Ill: The Need for Shared Decision-Making in a Technologically Sophisticated Healthcare Environment

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  • 发表日期：

    2025年

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  • Katherine Bakke

摘要

Patients with acute critical illness often require emergency surgery. In these situations, the risks of surgery are high, whereas the benefits of surgery may be marginal or debatable. This places the surgeon and the patient (or their surrogate decision-maker) in a complex situation, where the ethics regarding the “right” decision are not clear and decisions regarding treatment must be made expeditiously. This chapter explores the issues involved in the decision-making process for a severely ill patient with an acute surgical condition through the use of both personal vignette and literature review. The chapter concludes by focusing on shared decision-making and how this technique remedies many of the ethical concerns facing both surgeons and patients during these complex, challenging clinical situations.