Join Neva as she talks about the intriguing possibility of ghost surgeries. What kind of dilemma would propel a surgeon to swap patients mid-surgery, without the consent of the patient? Ultimately, could ghost surgery be the right decision depending on the circumstance? Listen to the episode to find out how Neva reasons through this moral gray area. What would you do in this situation?
DISCLAIMER: This episode is not intended to discredit the merit of the healthcare industry in any way. Rather to explore the possibilities of a rare medical scenario.
Join Neva as she talks about the intriguing possibility of ghost surgeries. What kind of dilemma would propel a surgeon to swap patients mid-surgery, without the consent of the patient? Ultimately, could ghost surgery be the right decision depending on the circumstance? Listen to the episode to find out how Neva reasons through this moral gray area. What would you do in this situation?
DISCLAIMER: This episode is not intended to discredit the merit of the healthcare industry in any way. Rather to explore the possibilities of a rare medical scenario.
Boo! Sorry, didn’t mean to scare you. Welcome back to Alphabet Soup. Today’s episode is about ghost surgeries. It’s a very mysterious subject! Because no one studies or tracks how many of them occur each year. But thankfully there are non-spectral footprints left behind in the form of lawsuits, that lets us know that ghost surgeries really do exist. Now you must be wondering, what are these ghost surgeries? For today’s episode I’ll be sharing a story that my friend Casper the ghost told me. Casper has seen a ghost surgery unfold firsthand. So, don’t ring the ghostbusters on him! Because he’s about to reveal this mystery.
Quick disclaimer, before I get started, today’s topic of ghost surgeries can be controversial in the healthcare industry. Because of ghost surgeries discreet, and well, unlawful nature there have been no studies that have been able to record how many ghost surgeries occur each year throughout the world. This episode is not to disgrace the merit of the healthcare industry in any way. Rather just to talk about an intriguing, and completely possible, medical scenario.
Ok, let’s get into Casper’s story! He tells me that one day he was at the local teaching hospital, and not to get a boo-ster shot! He was actually shadowing the most experienced doctor at the hospital, let’s call him Dr. B. Dr. B had just begun a scheduled spine surgery on Mr. Gray, when an emergency case rushed in; the victim was the son of the hospital’s biggest benefactor who demanded Dr. B’s care. And although Dr. B was reluctant to leave the sedated Mr. Gray, to tend to the emergency, the hospital was much more desperate to keep their most prominent monetary support. In fact, they were desperate enough to risk their image as a renowned hospital. Dr. B, threatened with his job, hesitantly agreed to switch operations.
What would happen to Mr. Gray? Similarly, the hospital threatened to withdraw a med student from their highly-selective residency program. The situation pressured him to suppress conflicting feelings and perform the ghost surgery, despite the lack of informed consent to operate on Mr. Gray. Sadly, Mr. Gray’s surgery did not go well, and he only discovered the switch once he requested his medical records and found the student’s name under the operating surgeons instead of Dr. B’s.
So, what is ghost surgery? Basically, it’s a surgery when your surgeon was not the one you consented to. It’s kind of a moral gray area that could impose a daunting dilemma on those involved. Could this be why there continues to be no interest in tracking the amount of ghost surgeries that occur each year? Today, I would like to explore reasons why doctors who are put in this dilemma would choose to go through with the ghost surgery? and ultimately whether deciding to perform a ghost surgery could be the right decision to make depending on the situation.
To reason my way through this gray area I’m going to applying four criteria that most people would reasonably expect in a medical setting: Truth, Fairness, Benefits vs. Harms, and precedents of Goodwill. Starting with truth. We all expect honesty from our healthcare professionals. In Casper’s story, regardless of whether both surgeons were unwilling, they did end up sacrificing their patient’s trust by lying to Mr. Gray. Ghost surgery has not met the criteria of Truth.
What about fairness? The outcome of the ghost surgery was that the benefactor’s son was saved by the work of Dr. B, and the hospital sustained their donation. But Mr. Gray’s spine surgery left him a paraplegic, paralyzed from the waist down; he may never recover. Would the result have been different if Dr. B had operated? Ghost surgery was most definitely not fair to Mr. Gray, who’s trust was betrayed, and who’s health was impaired. Fairness was not a standard that was met.
What about the benefits of ghost surgery? Were there more benefits than harms? From the hospital’s perspective, keeping their largest donor meant the hospital could continue to benefit many people, so ghost surgery was a sacrifice made for the benefit of the greater good. But now Mr. Gray is pressing charges against the hospital in a case that has reached the Supreme Court. The entire hospital’s credibility as a highly-esteemed clinic is stained by the actions of a handful of staff, the benefactor’s investment ran dry and Mr. Gray faces a life of paralysis. Ghost surgery did not reap more benefits than harms to all concerned, so it does not satisfy this criteria either.
Finally, did ghost surgery create examples of goodwill? Mr. Gray's paralysis is an inconvenience: he cannot drive or take full responsibility for his personal care. He has also faced the crippling realization that the doctors we have learned to trust are not immune to malpractice. This experience could pollute Mr. Gray’s willingness to embrace human connection with healthcare workers in the future, and possibly with anyone that he thought he could trust too. The initial goodwill of a clinic with healthcare workers aiming to provide quality care, is replaced by a vicious cycle of resentment: Mr. Gray resents Dr. B and the resident who lied, Dr. B and the resident resent the hospital’s threats that ruined their career, and the hospital resents the demanding benefactor.
Casper and I agree that Ghost surgery fails to meet all 4 of the reasonably expected criteria. Therefore, the answer to a seemingly complex issue with gray areas and pitfalls turned out to be as clear as a ghost, once we had genuinely reasoned our way through it. I have to mention that I did speak to Dr. Mark Reeves, who was a guest on Alphabet Soup in episode 7 (which you should definitely check out if you haven’t already), and he firmly assured me that ghost surgeries would almost never happen in the United States. He explained that the process of surgery in the states is extremely tightly regulated and there are a lot of measures to ensure the patient’s safety and rights are maintained. But I thought it was interesting to talk about the possibility of ghost surgeries occurring in the world. Especially because, in the grand scheme of things, it’s reasonable to assume that there have been many unrecorded cases of successful ghost surgeries that did not harm anyone. Even so, ghost surgery is an ethical gray area and if we only applied the Truth criteria, it would fail in every situation. When we are faced with a dilemma, instead of looking for ways to justify our decision, we should try to apply Truth, Fairness, Benefits vs. Harms, and whether it will set the precedent of Goodwill. This way, we can navigate towards the right decision and discover that the answer to our dilemma may not be as mysterious as it seems!
I hope you enjoyed today’s episode! For today’s bit I’m doing a shameless plug of alphabet soup’s Instagram handle. Make sure to go follow on Instagram for some inspirational content and show updates! Have a great week, guys and I’ll see you next time.