AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. October 1999, Volume 1, Number 2.

Cases in Law and Ethics

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The Ethics of "Ghost" Surgery

A case exploring whether it's appropriate for another surgeon to substitute when the treating surgeon is unavailable for surgery.

Both ethics and law address norms that govern physicians’ behavior. Many view the law as a baseline for articulating the limits placed on individuals living within society as well as an enabling device to facilitate social relationships. Encompassing as the law may be in some areas of human conduct, in many others, it is silent. In the absence of legal norms or prohibitions, physicians often find guidance in the standards arrived at through ethical reasoning.

To guide students through the process of ethical reasoning and to acquaint them with case law, a new case study will appear every 2 to 4 weeks. Students will be given legal and/or ethical opinions to assist their decision-making.

October Case Scenario

George G, a patient complaining of low back pain radiating into his left leg with numbness and tingling of his left foot, consulted Dr. Quimby, a surgeon. Dr. Quimbly recommended that Mr. G undergo corrective surgery. Dr. Quimbly informed Mr. G about risks associated with anesthesia, but did not discuss risk associated with drop foot. Before anesthesia was administered, a nurse came in and handed Mr. G a form, "Consent to Operation, Anesthetics, and Special Procedures." After the surgery, Mr. G developed a drop foot, and Dr. Quimbly recommended that he undergo additional surgery. Mr. G wanted a second opinion and requested his medical records. He learned that because Dr. Quimbly did not arrive on time to perform the surgery, another surgeon had performed the procedure. Mr. G was very upset that Dr. Quimbly had not performed the surgery and that a "ghost surgeon" had been substituted.

May a "ghost surgeon" be substituted when the treating surgeon is unavailable?

See what the AMA Code of Medical Ethics says about this topic in Opinion 8.16 Substitution of surgeon without patient's knowledge or consent. American Medical Association. Code of Medical Ethics 2008-2009 Edition. Chicago, IL: American Medical Association; 2008:284.

The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.