Coping with patient death: the surgeon's perspective

Surgeons' attitudes to intraoperative death: questionnaire survey

A study in this week's BMJ finds that many surgeons continue to operate on the same day that a patient dies during surgery, despite suggestions that a surgeon should not operate for a period of 24 hours after such an event, for psychological reasons.

These findings are not surprising as it has been suggested that surgeons are able to cope with situations that might be thought of as stressful to others, report the authors.

Forty-four orthopaedic surgeons were surveyed about their experiences of losing patients during surgery (intraoperative death), based on concerns raised by a recent inquiry and related issues. Of 31 questionnaires returned, 16 surgeons experienced the death of a patient during surgery, and 13 performed further operations that day. All those who continued to operate felt their competence had not deteriorated.

Eight of the surgeons who experienced the death of a patient during surgery felt that some time without operating would have been advisable. Most surgeons thought counselling should be offered, although the majority of these felt they would not have taken up this offer.

"We were not surprised to find that all but one of the surgeons continued to operate and that the prevailing attitude was one of 'it's part of the job,'" say the authors. Clearly, there is no general consensus among the orthopaedic surgeons about how to cope with intraoperative death, they conclude.

Contacts:

Ian Smith, Orthopaedic Specialist Registrar or M W Jones, Consultant Orthopaedic Surgeon Department of Orthopaedics, Ysbyty Gwynedd, Bangor, Gwynedd, Wales. Email: lasoksmith@aol.com