Maintaining standards of excellence
To optimise success in protecting life and
health to an acceptable standard, surgeons must only offer specialised
treatment in which they have been properly trained. To do so will entail
sustained further education throughout a surgeon’s career in the wake of new
surgical procedures. While training, surgery should only be practised under
appropriate supervision by someone who has appropriate levels of skill. Such
skill can only be demonstrated through appropriate clinical audit to which all
surgeons should regularly submit their results. When these reveal unacceptable
levels of success, no further surgical work of that kind should continue unless
further training is undergone under the supervision of someone whose success
rates are satisfactory. To do otherwise would be to place the interest of the
surgeon above that of their patient, an imbalance which is never morally or
professionally appropriate.
Surgeons
also have a duty to monitor the performance of their colleagues. To know that a
fellow surgeon is exposing patients to unacceptable, levels of potential harm
and to do nothing about it is to incur partial responsibility for such harm when
it occurs. Surgical teams and the institutions in which they function should
have clear protocols for exposing unacceptable professional performance and
helping colleagues to understand the danger to which they may exposing
patients. If necessary, offending surgeons must be stopped from practising
until, again, they can undergo further appropriate training and counselling.
Too often such danger has had to be reported by individuals whose anxieties have
not been properly heeded and who have been professionally pilloried rather than
congratulated for their pains. Surgeons and anyone else discovered to
participate in such coverup and ostracism should share the blame and punishment
for any resulting harm to patients.