By Paul Henry / in , , , , , , , , , , /


>>Hello, my name is Fabian Johnston and I am an Assistant Professor of Surgery at the Johns Hopkins
University School of Medicine and I’d like to thank the Journal of the American
College of Surgeons for the opportunity to
discuss our recent paper. End-of-life decision making is always hard but it’s particularly difficult when a patient and their
caregivers encounter a surgeon in an emergency situation. And it’s because of this that we decided to embark on this study to understand how shared decision making occurs between a patient, their
caregivers, and a surgeon. When we analyze our data,
five major themes arose. First was surgeon’s judgment. This was affected by the length of time the surgeon was in practice,
where they were trained, and the environment that
they were involved in. Second was a surgeon’s introspection in terms of how much they
thought about this process and their interactions with
the patients along this. The third theme was pressures to operate. The fourth theme was
the cost of operating. This was actually the emotional,
physical, and social cost of operating on a patient that
surgeons felt was important. Lastly was the idea of
futility and uncertainty. In conclusion, we found
that shared decision making for patients with acute
surgical illness is hard. But there are a few
takeaways we wanna give. Number one, communication training. We think surgeons should have improved and more communication training for patients at the end of life. Number two, there needs to be
increased support from peers and from the institution. And number three, there needs
to be improved utilization of existing tools to aid the surgeon. I’d like to thank the Journal of the American College of Surgeons for the opportunity to share our work.


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