2022 Harvard Surgical Ethics Conference

4 Virtual Sessions: June 6, 13, 21 and 27

The Harvard Medical School Center for Bioethics’ Surgical Ethics Working Group (SEWG) offered a virtual surgical ethics conference over four weeks in June. Each week featured a different topic that explored timely and controversial questions in surgery today. Topics were relevant to practicing surgeons, surgery residents, medical students, nurses, nursing students, advanced practice providers, bioethicists, graduate students, and other health care professionals. Participants learned how to accurately distinguish and discuss the ethical challenges associated with these surgical issues. Registrants who attended all four sessions livereceived a certificate of completion following the conference. Review the articles referenced during each session here.

Event Details and Speakers

  • Ethical Challenges in Global Surgery

    Monday, June 6, 2022 | Recording Available
    7–8:30 p.m. ET

    Watch the online recording here on our YouTube channel.

    Short-Term Surgical Mission (STSM) trips originated as relief trips wherein surgeons and doctors from high-income countries observed the great burden of surgical disease in low- and middle-income countries (LMICs) and traveled to provide essential surgical care before returning to their regular practice. While these trips have historically served to “do good” by providing surgical care to populations in which surgical providers are scarce, these trips are fraught with sustainability and ethical challenges as well. This session discussed the gaps in access to safe and affordable surgical care and our moral obligation to address these gaps, whether STSMs should play a role in providing surgical care in LMICs, and the ethics of bringing complex surgical procedures to LMICs.

    During this session, Bethany Hedt-Gauthier, PhD discussed Global Surgery Needs and Moral Obligation. Rashi Jhunjhunwala, MD, MA explored the Ethics of Short-term Surgical Missions (STSM). Michelle Joseph, MBBS, MSc, PhD, FRCS covered Complex Surgical Procedures in Low- and Middle-Income Countries (LMICs): Yes, No, or Maybe. John Meara, MD, DMD, MBA moderated the session.

    Speakers
    Bethany Hedt-Gauthier, PhD

    Bethany Hedt-Gauthier, PhD
    Associate Professor
    Global Health and Social Medicine
    Harvard Medical School

    Associate Professor
    Department of Biostatistics
    Harvard T.H. Chan School of Public Health

    Rashi Jhunjhunwala, MD, MA

    Rashi Jhunjhunwala, MD, MA
    Surgical Resident
    Beth Israel Deaconess Medical Center

    Senior Fellow
    Program in Global Surgery and Social Change
    Harvard Medical School

    Michelle Joseph, MBBS, MSc, PhD, FRCS

    Michelle Joseph, MBBS, MSc, PhD, FRCS
    Instructor
    Global Health and Social Medicine
    Harvard Medical School

    Moderator
    John Meara, MD, DMD, MBA

    John Meara, MD, DMD, MBA
    Professor of Surgery
    Harvard Medical School

    Plastic Surgeon-in-Chief
    Department of Plastic and Oral Surgery
    Boston Children's Hospital

     

  • Ethical Issues in Gender Surgery

    Monday, June 13, 2022 | No Recording Available
    7–8:30 p.m. ET

    Using a case presentation, this session debated the proposition that surgical reconstruction of an infant with atypical genitalia is ethically justified. In addition, the standard types of gender-affirming procedures were reviewed, followed by the process for identifying and addressing key ethical, legal, and contextual issues through discussion with hospital, local, and community entities and stakeholders. Primary issues included age-appropriateness and age limits, obtaining informed consent and assent, recruitment of ancillary services for comprehensive care delivery, education of staff, and addressing existing access inequities for transgender and gender non-binary patients.

    During this session, David A. Diamond, MD and Jonathan Marron, MD, MPH reviewed the Ethical Considerations in the Surgical Treatment of Infants with Atypical Genitalia. Amir Taghinia, MD, MPH, MBA explored the Ethical Considerations in Establishing a (Trans-)Gender Affirming Surgical Center at Boston Children's Hospital. Douglas W. Hanto, MD, PhD, MBE moderated the session.

    Speakers
    David A. Diamond, MD

    David A. Diamond, MD
    Professor of Urology and Pediatrics
    University of Rochester Medical Center

    Jonathan Marron, MD, MPH

    Jonathan Marron, MD, MPH
    Attending Physician, Pediatric Hematology/Oncology
    Dana-Farber Cancer Institute

    Instructor in Pediatrics
    Harvard Medical School

    Attending Physician, Cancer and Blood Disorders Center
    Clinical Ethicist
    Boston Children's Hospital

    Teaching Faculty
    Harvard Medical School Center for Bioethics

    Amir Taghinia, MD, MPH, MBA

    Amir Taghinia, MD, MPH, MBA
    Staff Surgeon
    Department of Plastic and Oral Surgery
    Boston Children's Hospital

    Associate Professor of Surgery
    Harvard Medical School

    Moderator
    Douglas W. Hanto, MD, PhD, MBE

     

    Douglas W. Hanto, MD, PhD, MBE

    Chair, Surgical Ethics Working Group
    Harvard Medical School Center for Bioethics

    Lewis Thomas Professor of Surgery Emeritus
    Harvard Medical School

  • Ethical Considerations in Surgical Innovation

    Tuesday, June 21, 2022 | Recording Available
    7–8:30 p.m. ET

    Watch the online recording here on our YouTube channel.

    Innovation adds another dimension of risk to the dangers of surgery. Heroic patients, parents, and surgeons have bravely participated in these innovative efforts to advance surgical treatment. This session outlined the process of using new devices in the operating room, from development to the documentation of outcomes. In addition, the session covered some of the ethical challenges that have been accepted in the operating room and recommended management approaches based on experiences at the institutional and national professional society level.

    During this session, Richard Whyte, MD, MBA discussed the Implementation of New Technology. Theresa Williamson, MD explored the Implementation of New Devices. John E. Mayer, Jr., MD and Martin F. McKneally, MD, PhD described Collaborative Development and Introduction of New Procedures. Louise P. King, MD, JD moderated the session.

    Speakers
    Richard Whyte, MD, MBA

    Richard Whyte, MD, MBA
    Vice Chair of Quality
    Safety and Clinical Affairs
    Beth Israel Deaconess Medical Center

    Professor of Surgery
    Harvard Medical School

    Theresa Williamson, MD

    Theresa Williamson, MD
    Assistant Professor of Neurosurgery
    Massachusetts General Hospital

    Course Instructor
    Vice Chair, Surgical Ethics Working Group
    Harvard Medical School Center for Bioethics

    John E. Mayer, Jr., MD

    John E. Mayer, Jr., MD
    Senior Associate in Cardiac Surgery
    Boston Children’s Hospital

    Professor of Surgery
    Harvard Medical School

    Martin F. McKneally, MD, PhD

    Martin F. McKneally, MD, PhD
    Founding Chair and Member
    Surgical Ethics Working Group
    Harvard Medical School Center for Bioethics

    Lecturer on Surgery
    Beth Israel Deaconess Medical Center

    Professor Emeritus of Surgery
    Member of Joint Centre of Bioethics
    University of Toronto

    Moderator
    Louise P. King, MD, JD

    Louise P. King, MD, JD
    Assistant Professor,
    Director of Research, Minimally Invasive Gynecologic Surgery
    Associate Program Director, Fellowship in Minimally Invasive Gynecologic Surgery
    Brigham and Women's Hospital

    Director of Reproductive Bioethics
    Co-Director, Ethics, Essentials of the Profession
    Harvard Medical School Center for Bioethics

    Affiliated Faculty, Petrie-Flom Center
    Harvard Law School

  • Disparities in Surgery and Obligations to Correct

    Monday, June 27, 2022 | Recording Available
    7–8:30 p.m. ET

    Watch the online recording here on our YouTube channel.

    Health care disparities, including differences in access and outcomes due to factors such as race and ethnicity, are well documented across multiple surgical procedures. These disparities in surgical care are caused by social determinants of health rooted in slavery and structural racism. Approaches to mitigating these disparities and our moral obligations to reduce surgical disparities will be discussed. This session will also examine the ways in which the principle of justice is competing with that of patient autonomy and reflect on potential pitfalls and benefits.

    During this session, Douglas W. Hanto, MD, PhD, MBE will explore the Disparities in the Care of Black, Indigenous, Latinx, and People of Color (BILPOC). Theresa Williamson, MD will examine Racism and Bias in Surgical Training. Piroska Katalin Kopar, MD, FACS will discuss How We Can Achieve Social Justice in Health Care and Surgery. Theresa Williamson, MD will moderate the session.

    Speakers
    Douglas W. Hanto, MD, PhD, MBE

    Douglas W. Hanto, MD, PhD, MBE

    Chair, Surgical Ethics Working Group
    Harvard Medical School Center for Bioethics

    Lewis Thomas Professor of Surgery Emeritus
    Harvard Medical School

    Theresa Williamson, MD

    Theresa Williamson, MD
    Assistant Professor of Neurosurgery
    Massachusetts General Hospital

    Course Instructor
    Vice Chair, Surgical Ethics Working Group
    Harvard Medical School Center for Bioethics

    Piroska Katalin Kopar, MD, FACS Piroska Katalin Kopar, MD, FACS
    Assistant Professor of Surgery
    Director of Center for Humanism and Ethics in Surgical Specialties,
    Section of Acute and Critical Care Surgery
    Washington University School of Medicine
    Moderator
    Theresa Williamson, MD

    Theresa Williamson, MD
    Assistant Professor of Neurosurgery
    Massachusetts General Hospital

    Course Instructor
    Vice Chair, Surgical Ethics Working Group
    Harvard Medical School Center for Bioethics