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Ethics in Cardiothoracic Surgery

Broadcast of Surgical Procedures as a Teaching Instrument in Cardiothoracic Surgery

American Association for Thoracic Surgery, Beverly, Massachusetts; and The Society of Thoracic Surgeons, Chicago, Illinois

^_* Address correspondence to Dr Sade, Institute of Human Values in Health Care, Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, Ste 409, Charleston, SC 29425 (Email: sader@musc.edu).

The first 300 words of the full text of this article appear below.

	Introduction

 
Physicians have had an obligation to teach their art to others at least since the time of Hippocrates. Instruction during live operations has been in widespread use at least since the 19th century. Until recently, such intraoperative instruction was necessarily a local event, with teacher and pupil standing over the open surgical wound. In the latter part of the 20th century, transmission of images electronically over long distances became possible, and broadcasts of cardiothoracic operations in real time have become popular in recent years worldwide, especially in Europe.

As the use of these technologies has increased, the intensity of controversy surrounding them has grown in parallel. The disagreement has centered on questions of potential or real harm to patients related to broadcasts of operations and the ill-defined value of such broadcasts. Several national surgical associations have banned the practice from some or all of their meetings, including the American College of Obstetricians and Gynecologists and the American College of Surgeons (M. McGrath, personal communication, February 9, 2006).

Out of concern for patient safety, several Japanese cardiac, thoracic, and vascular surgery societies created a Joint Committee to examine the controversy, and on August 10, 2007, the Joint Committee issued guidelines for regulating live surgery broadcasts at their meetings [1]. Their report is being considered for adoption by other surgical associations worldwide and has been carefully considered by both the American Association for Thoracic Surgery (AATS) and The Society of Thoracic Surgeons (STS).

The STS asked its Standards and Ethics Committee to examine this issue, and the committee recommended that the Japanese guidelines not be adopted, that public live surgery broadcasts not be permitted, and that such broadcasts not be permitted at its annual meeting. In response, The STS Board of Directors appointed a task force, under the leadership of . . . [Full Text of this Article]