Debates on Surgical Ethics for Young Vascular Surgeons.

During a recent semester at the Seoul National University (SNU) Graduate School, I developed a new lecture series titled “Debates on surgical ethics” for postgraduates majoring in Surgery. I am not a specialist in surgical ethics, but I am very interested in education and ethics, and enjoy reading the articles published in the section “Surgical Ethics Challenges” in the Journal of Vascular Surgery (JVS), edited by Dr. James W. Jones [1,2]. Therefore, I designed a practical lecture series for young surgeons to introduce many ethical issues encountered in daily practice, discuss personal experiences and ideas on specific issues, and uncover hidden ethical problems in the surgical field. The lecture plan describes the course as follows: “Surgical techniques and devices have been rapidly developing and advancing in recent years. However, current medical ethics cannot address the delicate issues that arise with novel advanced surgical treatments. We aim to collect data on modern surgical ethics involved in various clinical scenarios and discuss the pros and cons of each topic. These debates will clarify the concept of future surgical ethics and help develop guidelines for surgical ethics. After providing the related texts and materials, debates will be held by students in the roles of moderator and those arguing for the pros and cons of a particular viewpoint, under the supervision of a facilitator professor.” The lecture series was held every Thursday afternoon and included various ethical issues with the following titles: 1) Surgical ethics concerning endovenous varicose vein (VV) treatment; 2) Turf war: Ethics of professional territorialism; 3) Surgical tourism; 4) Ethics of live surgery demo or broadcast; 5) They decide who lives and who dies; 6) Ethics of organ donation and transplantation; 7) Industry and surgical innovation; 8) Ethical price of stardom and show doctors; 9) Operative over-scheduling; 10) The question of an impaired surgeon dilemma; 11) Discovering over-treatment; 12) Who should protect the public against bad doctors?; 13) Refusal of life-saving treatment in the aged; and 14) Ethical problems specific to surgery. Many of the titles were benchmarked based on the JVS Surgical Ethical Challenges and other articles [3,4]. However, only eight students enrolled in the class. I changed the roles of the presenter of a specific issue allowing for free discussion with the participants, and every student was encouraged to speak about their experiences and ideas on that issue. We enjoyed the weekly Thursday meetings more than expected. Similar to the film “Tuesdays with Morrie”, I enjoyed every “Thursday with surgical ethics students” for the last four months. After the final class, I conducted an anonymous survey on the lecture course, and most postgraduate students gave positive feedback. One student wrote “Thanks to the materials provided, I discovered something new in the field of ethics. In particular, for the first time, I read an interesting article entitled ‘They decide who lives and who dies’ [5]. I then read several similar articles. It was also interesting to read about the personal problems of doctors, such as alcoholism. Thank you for this interesting course.” Arguably, the most interesting lecture topic that was chosen for discussion was “impaired surgeons’ dilemma”, which dealt with the personal problems of surgeons with regard to drug and alcohol abuse and impaired skills in some novel techniques. This is not an easy issue to discuss, Edorial