In its nearly 170-year history in this country, anesthesiology has expanded far beyond the operating room into obstetrics, pain management, critical care and the full range of perioperative care. The specialty’s growth has brought complex ethical questions with it.
This month, AMA Journal of Ethics focuses on the key medical-surgical specialty. Contributors to the March issue examine some of those concerns—the use of opioids and the effects of bias in pain treatment; challenges to interspecialty professionalism, particularly in operating room and critical care settings; and the ability of seriously ill patients to give fully informed consent to (or refusal of) extracorporeal life support.
March’s issue includes the following stories:
- “Ethics and the practice of anesthesia.” The journal’s March editor discusses how anesthesiologists made essential contributions to the development of critical care management, pointing to their expertise in physiology, pharmacology and resuscitation.
- “Opioids for nonmalignant chronic pain.” Given full information about the risks of long-term opioid therapy, patients often see the value of exploring other options rather than thinking their physicians are reluctant to prescribe narcotics for fear of litigation or regulatory action.
- “Ethical tenets of perioperative care: Finding my surgical way home.” In this commentary, the authors discuss the perioperative surgical home, in which the anesthesiologist coordinates care with other team members to provide seamless continuity from preoperative evaluation to postoperative care.
- “The influence of social values on obstetric anesthesia.” The first women’s movement in the mid-19th century endorsed anesthesia during childbirth, and some of the very patterns of obstetric practice that became anathema to the natural childbirth movement a century later.
Be sure to listen to March’s podcast on the development of anesthesiology and the “balanced anesthesia” approach, and answer this month’s ethics poll. Follow the journal on Twitter for more ethics news.
