Surgeon experience aids assessment of futility

(HealthDay)—More experienced surgeons are more confident in their assessments of perceived futility, according to a study recently published in the Journal of the American College of Surgeons.

Rachel S. Morris, M.D., from the Medical College of Wisconsin in Milwaukee, and colleagues conducted semi-structured interviews with 20 practicing surgeons at two large academic medical centers. The questions and case vignettes were used to assess surgeons’ perceptions of shared decision-making with older surgical patients with comorbidities.

Through thematic analysis, the researchers identified six major themes: responsibility for the decision to operate, perceived futility, surgeon judgment, surgeon introspection, pressure to operate, and costs of the operation. There was universal recognition that perceived futility was a contraindication to surgical intervention. Given the challenge of defining futility, participants emphasized the importance of patients’ self-determined risk-to-benefit analysis when considering surgery. Communicating to patients that a condition was not amenable to an operation and reserving the right to refuse to operate was more common among experienced surgeons.

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