Back to Chapter 2 Consent, Communication & Decision Making
Opinion 2.1.6

Substitution of Surgeon

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Patients are entitled to choose their own physicians, which includes being permitted to accept or refuse having an intervention performed by a substitute. A surgeon who allows a substitute to conduct a medical procedure on his or her patient without the patient’s knowledge or consent risks compromising the trust-based relationship of patient and physician.

When one or more other appropriately trained health care professionals will participate in performing a surgical intervention, the surgeon has an ethical responsibility to:

  1. Notify the patient (or surrogate if the patient lacks decision-making capacity) that others will participate, including whether they will do so under the physician’s personal supervision or not.
  2. Obtain the patient’s or surrogate’s informed consent for the intervention, in keeping with ethical and legal guidelines.
AMA Principles of Medical Ethics: I, II, IV, V
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Opinion 2.1.1

Informed Consent

Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.
Opinion 2.3.6

Surgical Co-Management

Surgical co-management refers to the practice of allotting specific responsibilities of patient care to designated clinicians. Such arrangements should be made only to ensure the highest quality of care.