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
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Ethical Challenges in Global Surgery
Monday, June 6, 2022 | Recording Available7–8:30 p.m. ETWatch 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
Associate Professor
Global Health and Social Medicine
Harvard Medical SchoolAssociate Professor
Department of Biostatistics
Harvard T.H. Chan School of Public HealthRashi Jhunjhunwala, MD, MA
Surgical Resident
Beth Israel Deaconess Medical CenterSenior Fellow
Program in Global Surgery and Social Change
Harvard Medical SchoolMichelle Joseph, MBBS, MSc, PhD, FRCS
Instructor
Global Health and Social Medicine
Harvard Medical SchoolModerator
John Meara, MD, DMD, MBA
Professor of Surgery
Harvard Medical SchoolPlastic Surgeon-in-Chief
Department of Plastic and Oral Surgery
Boston Children's Hospital -
Ethical Issues in Gender Surgery
Monday, June 13, 2022 | No Recording Available7–8:30 p.m. ETUsing 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
Professor of Urology and Pediatrics
University of Rochester Medical CenterJonathan Marron, MD, MPH
Attending Physician, Pediatric Hematology/Oncology
Dana-Farber Cancer InstituteInstructor in Pediatrics
Harvard Medical SchoolAttending Physician, Cancer and Blood Disorders Center
Clinical Ethicist
Boston Children's HospitalTeaching Faculty
Harvard Medical School Center for BioethicsAmir Taghinia, MD, MPH, MBA
Staff Surgeon
Department of Plastic and Oral Surgery
Boston Children's HospitalAssociate Professor of Surgery
Harvard Medical SchoolModerator
Douglas W. Hanto, MD, PhD, MBE
Chair, Surgical Ethics Working Group
Harvard Medical School Center for BioethicsLewis Thomas Professor of Surgery Emeritus
Harvard Medical School -
Ethical Considerations in Surgical Innovation
Tuesday, June 21, 2022 | Recording Available7–8:30 p.m. ETWatch 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
Vice Chair of Quality
Safety and Clinical Affairs
Beth Israel Deaconess Medical CenterProfessor of Surgery
Harvard Medical SchoolTheresa Williamson, MD
Assistant Professor of Neurosurgery
Massachusetts General HospitalCourse Instructor
Vice Chair, Surgical Ethics Working Group
Harvard Medical School Center for BioethicsJohn E. Mayer, Jr., MD
Senior Associate in Cardiac Surgery
Boston Children’s HospitalProfessor of Surgery
Harvard Medical SchoolMartin F. McKneally, MD, PhD
Founding Chair and Member
Surgical Ethics Working Group
Harvard Medical School Center for BioethicsLecturer on Surgery
Beth Israel Deaconess Medical CenterProfessor Emeritus of Surgery
Member of Joint Centre of Bioethics
University of TorontoModerator
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 HospitalDirector of Reproductive Bioethics
Co-Director, Ethics, Essentials of the Profession
Harvard Medical School Center for BioethicsAffiliated Faculty, Petrie-Flom Center
Harvard Law School -
Disparities in Surgery and Obligations to Correct
Monday, June 27, 2022 | Recording Available7–8:30 p.m. ETWatch 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
Chair, Surgical Ethics Working Group
Harvard Medical School Center for BioethicsLewis Thomas Professor of Surgery Emeritus
Harvard Medical SchoolTheresa Williamson, MD
Assistant Professor of Neurosurgery
Massachusetts General HospitalCourse Instructor
Vice Chair, Surgical Ethics Working Group
Harvard Medical School Center for BioethicsPiroska 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 MedicineModerator
Theresa Williamson, MD
Assistant Professor of Neurosurgery
Massachusetts General HospitalCourse Instructor
Vice Chair, Surgical Ethics Working Group
Harvard Medical School Center for Bioethics