1999 Annual Meeting
Scientific Program
|
American Academy of Orthopaedic Surgeons
1999 Annual Meeting Scientific Program |
Thursday, February 4, 1999
10:30 AM - 12:30 PM
Location: A6/7
SYMPOSIUM
Charles H Epps Jr, MD, Washington, DC
Jay R Lieberman, MD, Los Angeles, CA
Rosamond Rhodes, PhD, New York, NY
Neil Wenger, MD, Los Angeles, CA
It has recently come to light that physicians may be exceptionally well trained in the medical and surgical management of diseases but may have little knowledge with which to handle ethical dilemmas. This symposium plans to present a series of orthopaedic cases dealing with a variety of ethical issues. These include: patient noncompliance with treatment, patients with diminished capacity, family interference in treatment plans and doctor-patient confidentiality. There will be approximately four to six cases presented by the moderator to a panel consisting of two orthopaedic surgeons, well versed in professional ethics, and two medical bioethicists. We would like to open the discussion of each case to audience members for additional discussion.
Case 1
The case describes a mildly mentally retarded young adult who has fractured his hip. The physician explains that the optimal treatment is surgical repair and describes the alternatives, including bedrest, that might yield an unsatisfactory, painful disability. The patient refuses surgery. The patient recites his clinical situation and reason for refusal. The patient's mother instructs the physician to proceed with the surgery. She adds that she makes all of the important decisions for her son.
Objectives
Case 2
This case describes a particularly bad day for an orthopaedic surgeon who sees several difficult patients in a row. One patient has symptoms out of proportion to his physical findings. He is awaiting a lawsuit settlement. The second patient is a chronic pain patient who is opiate dependent. The third is a continuity patient waiting to see the physician. The front office notes that she has lost her insurance coverage.
Objectives
Case 3
A spine surgeon recently took a class in microdisectomy but has never performed the procedure. A patient with a symptomatic disc herniation requires surgery. The patient requests that a microdisectomy be performed because he understands there is less morbidity associated with this procedure. The physician must respond to the patient's request.
Objectives
Case 4
A patient whose capitated insurance requires a referral from a primary care gatekeeper, obtains an appointment with his previously visited orthopaedic specialist. He does not have a referral. He desires care for his low back pain. He asks the orthopaedic surgeon to to call his primary care physician to request permission for the visit and diagnostic testing. Neither may be clinically indicated. The specialist explains that he, like the patient must obey the managed care rules.
Case 5
A young orthopaedic surgeon who performs a large number of total hip replacements is asked by his Chairman why he is not using the prosthesi designed by the Chairman. The Chairman receives royalties from the hip design. The younger surgeon responds that the prosthesis that he uses has a well proven track record. The Chairman continues to pressure the surgeon.
Objectives
| Home | 1999 Meeting | Scientific Program |