Actual issues of deontological ethics in surgical oncology

Issues of deontological ethics in medicine were discussed in numerous papers, including publications of special conferences. N.N. Petrov in his book wrote: «Surgery depends on science, which is continuously growing and expanding. It also depends on the technique: hand, instrumental, electric, continuously developing and simplifying facing seemingly insurmountable difficulties. Teachers provide information about the science, and techniques to young surgeons, of whom all are keenly interested in it. But surgery is not limited to science and technology. Painfully affecting the human body, getting deeply inside it, surgery reaches the top of its opportunities only in case when it is decorated with the highest manifestation of selfless care of the sick person, and that not only of his body, but also about the state of his mind». Much has changed during this period of time, more accurate diagnostic methods appeared, unprecedented success was achieved in anesthesiology and critical care. The article covers questions related to ethics arising while treating patients with malignancies. Various aspects of deontological ethics, i.e. proper attitude and decisions while treating patients with malignancies, have certain features specific for surgical oncology. Questions of contraindications to surgery are solved at different stages of the patient treatment: during outpatient examination, exploration, at operation itself, after completing surgery. Some examples of ethical errors are given. Conclusion on refusing the surgery should be, in every case, absolutely reliable, rigorously documented, which prohibits false solutions. Decision should be based on a clear understanding of the pathogenesis of the patient’s body changes in each case. The questions of indications for surgery, its feasibility and extent should be decided ex concilio.