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Review
. 2022 Jun:78:103845.
doi: 10.1016/j.amsu.2022.103845. Epub 2022 May 24.

A medical ethics review of elective orthopaedic surgery management during the pandemic COVID-19 Era

Muhammad Ardi Munir  1   2 , Pascal Adventra Tandiabang  3 , Amirah Basry  4 , Try Setyawati  4 , Nasrun  5 , Nur Azid Mahardinata  5 , Nurulhuda Rahman  6
Affiliations
Review

A medical ethics review of elective orthopaedic surgery management during the pandemic COVID-19 Era

Muhammad Ardi Munir et al. Ann Med Surg (Lond). 2022 Jun.

Abstract

Introduction: Orthopaedic surgeons may wonder what preparation and recuperation would be like during pandemics. We are concerned about the patient's safety during the operation. All surgical centres have received instructions to discontinue all elective surgery operations, although urgent surgical cases are still being carried out. This procedure should not be delayed in orthopaedic issues such as fracture repositioning surgery, as the unionization process is ongoing.

Methods: We gather review articles from a variety of sources. The keywords "Ethics," "COVID-19," "Elective Surgery," and "Orthopedic Surgery" were used to filter the documents. We found 863 documents and then set the criteria for including documents that we thought eligible for review articles, such as research journals and newspaper pieces from reliable sources, resulting in the discovery of 40 papers that met our requirements.

Result: We will discuss four basic principles of medical ethics: beneficence, nonmaleficence, autonomy, and justice. Orthopaedic surgeons will face many decisions that will challenge these ethical principles, especially in performing elective surgery during a pandemic.

Conclusion: Physicians must protect the most vulnerable, but they are under no obligation to administer treatment they believe to be ineffective. In individuals who are positive for COVID-19, orthopaedic surgical procedures have a significant mortality rate. Surgical leaders must remain attentive, and surgical services must be reintroduced gradually and carefully. A good option is to carry out treatment at a different place and time and ensure that the patient has tested negative for COVID-19 before the procedure, thereby creating safety for patients and health workers.

Keywords: Covid-19; Medical ethics; Non-emergency surgery; Orthopaedic elective surgery; Pandemic.

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Conflict of interest statement

During the COVID-19 pandemic, orthopaedic surgery is often delayed. Procrastination is caused by a misunderstanding. Many think that fracture surgery is not an emergency case, because it does not affect life, as a result, orthopaedic surgery is always placed last, even though we as orthopaedic surgeons always emphasize delaying orthopaedic surgery, especially fractures, can cause malunion because bone unionization continues, without knowing the bone alignment.

Figures

Fig. 1
Fig. 1
Perioperative management of elective surgery patient.
See this image and copyright information in PMC

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