Intended for healthcare professionals

Observations Ethics Man

Crouching tiger, hidden surgeon

BMJ 2011; 342 doi: (Published 15 June 2011) Cite this as: BMJ 2011;342:d3591
  1. Daniel K Sokol, honorary senior lecturer in medical ethics, Imperial College London
  1. daniel.sokol{at}

Why in surgery is there such a neglect of training in ethics?

Cast your eye down the list of delegates at any course in medical ethics. You will find represented a wide range of specialties: the usual batch of general practitioners and anaesthetists, intensivists, psychiatrists, oncologists, junior doctors, and even the occasional radiologist and pathologist. Yet there is one species of doctor that is as rare as the Siberian tiger: the surgeon. I must confess that my eyes light up when I see a surgeon on the list, and I scan the room hoping to catch a glimpse of the rare animal. When I see one in the flesh, he (for it usually is) tends, surprisingly, to be shy, crouching towards the back of the classroom or lecture theatre. More often than not he is an older creature. Without his tools and instruments, without his mask, exposed and alone, the surgeon in the ethics course has ventured into a foreign habitat.

The Royal College of Surgeons offers an extensive menu of training courses, from the cheerful “drawing for surgeons” to the bone chilling course on the Ilizarov method. Although a course exists on legal issues in surgery, there is no course on surgical ethics. Several royal …

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