Surgeons are reluctant to withdraw life support after making an error

A new study published in the July 2012 Annals of Surgery has found that surgeons are reluctant to withdraw life support after operating on a patient, and that this sentiment increases if the surgeon made an error during the procedure.

Findings of the survey of surgeons

In the new study, researchers asked 912 surgeons in the neurologic, cardiothoracic and vascular areas of practice to read and react to two hypothetical surgeries. In the first scenario, the surgeon made no errors and performed the surgery to the best of his or her abilities, but the operation failed to save the life of the patient. The patient's family asks the surgeon to withdraw life support. At this point, the surgeons surveyed in the study were asked how likely they were to fulfill the family's request and what influenced their decision.

In this scenario, 63 percent of surgeons reported they would be not at all likely or somewhat unlikely to grant the family's wish to withdraw life support, and 57 percent claimed they would recommend the family wait 10 days before considering withdrawing life support to give the patient's condition a chance to improve.

The second scenario was identical to the first except for one important difference: The surgeon made an error during the surgery. In this case, the surveyed surgeons were twice as likely to balk at the family's wish to withdraw life support.

In both instances, surgeons reported that their decisions to not withdraw life support were due to optimism about the patient's recovery and the belief that families cannot predict their loved one's future quality of life. They also reported a personal responsibility for the patient and that their ethical feelings about withdrawing life support contributed to their decisions.

Common surgical errors and how to prevent them

Surgeries occur under a variety of conditions. Some operations are planned and patients and doctors have many opportunities to discuss the procedure, while others are emergencies and the patient does not meet his or her surgeon until after the operation is complete. In either case, surgical errors can and do occur, often with devastating consequences.

Up to 40 times a week in the U.S., surgeons make severe mistakes known as wrong site, wrong procedure or wrong patient errors. As their names imply, these errors occur when surgeons operate on the wrong area of the body, perform the wrong surgery or perform surgery on the wrong patient, respectively. While 40 of these errors occur weekly in the U.S., some believe the numbers are probably higher since surgeons are not required to report when and if they make an error.

Surgical errors can also be caused by an error made in the diagnostic stage of a patient's care. For example, a wrong-patient error may occur if two patients' biopsy samples were incorrectly labeled during diagnosis, and a healthy patient receives an operation while the other, sick patient is discharged and led to believe he or she is healthy.

To prevent these types of errors from occurring, patients and their families need to aggressively advocate for themselves throughout all stages of the health care process. Patients should review their procedures with their surgeons immediately prior to the operation to confirm the site and surgery to be performed. Additionally, everyone on a patient's medical team should know the patient's name, date of birth and what operation he or she is to endure.

Surgical errors occur too frequently in the U.S. Until measures are taken to reduce surgical errors, patients must be their own advocates. If you or a loved one has been injured by a surgical error, please contact an experienced medical malpractice lawyer.

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