AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. October 2004, Volume 6, Number 10.

Test Questions

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Test Questions: Ethics in the Practice of Surgery

Ethics in the Practice of Surgery


If faced with a patient request for palliative surgery that is unlikely to achieve the patient's goals, the surgeon should, according to the case commentators:

A. Refuse and refer.
B. Try to convince the patient he or she doesn't want the surgery.
C. Assist the patient's transition from the desire for surgery to a realistic expectation of palliative care.
D. None of the above.


The best way to reduce the adverse effects of errors made before, during, or after surgery is, according to the Medical Education article, for:

A. Surgeons to acknowledge their limitations.
B. Surgeons to recognize the importance of the entire system of care.
C. The volume of surgeries to be lessened.
D. All of the above.
E. A and B.


A surprising cause of action in Dingle v Belin, in which a resident surgeon cut the patient's common bile duct during laparoscopic surgery, was:

A. Breach of Contract.
B. Negligence: No informed consent.
C. Negligence in the performance of surgery.
D. None of the above.


According to the Medicine and Society article, reality television shows involving plastic surgery treat the ethical issues raised by extreme cosmetic surgery:

A. Comprehensively.
B. Mockingly.
C. Not at all.
D. Only when they relate to financial incentives.


There is no FDA-equivalent to approve surgery protocols. According to the Policy Forum, a limitation of such an organization specific to surgery would be:

A. The necessity of training alongside testing of new technology.
B. An inability to keep up with rapidly changing technology.
C. Failure to compare competing devices.
D. All of the above.
E. A and C.


An anesthetized patient is undergoing surgery when the occasion arises for an additional unplanned, non-urgent procedure that appears to be low-risk and may be beneficial (eg, a mole is found). According to the commentator, the surgeon should:

A. Wait and contact the primary physician because he or she may be aware and involved in care of the problem in question.
B. Wait and involve the patient in any decisions about treatment.
C. Remove the mole to minimize the number of necessary medical interventions.
D. A and B.


The Op-Ed article identifies several reasons why surgeons are not readily taking up evidence-based surgery. Which of the following is (are) not among those reasons?

A. The boundaries between clinical care and clinical experimentation are not always clear.
B. The substantial difference between surgery and pharmaceutical interventions.
C. The available research evidence for surgery is of low quality.
D. The alleged insufficiency of research knowledge and skills among surgeons.
E. All of the above.


The Policy Forum article on the Universal Protocol suggests that major obstacles to eliminating wrong site, wrong person, and wrong surgery events include:

A. The deteriorating standards of medical education.
B. Lack of awareness of the prevalence of the problem.
C. The complexity of the causes of these mistakes.
D. All of the above.
E. B and C.


Which of the following is least important in determining the value of palliative surgery, as identified in the Clinical Pearl:

A. The surgery is technically feasible.
B. The patient's fitness, both physically and emotionally, for surgery and recovery.
C. Likely benefit to the patient from the surgery.
D. The surgeon's agreement with the patient's reasons for requesting the surgery.


The case involving the laparoscopic appendectomy illustrates the importance of supervision for surgery residents because supervision:

A. Is an important protection of patient safety.
B. Provides feedback on skill progression that would otherwise be unavailable.
C. Is a valuable tool throughout a surgeon's career.
D. All of the above.

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