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AANS Neurosurgeon | Volume 26, Number 3, 2017

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Under Pressure: The Surgeon’s Conundrum in Decision Making

Small Study Based on Subjective Interviews Explores Decision-Making Process in Life-and-Death Emergencies

In a small study based on conversations with 20 hospital-based surgeons, Johns Hopkins researchers say they found that most report feeling pressure to operate under severe emergency situations, even when they believe the patients would not benefit.

Results of the study highlight the multiple factors and complexity that underlie decision-making, quality care and patient outcomes in life-and-death emergency situations, the researchers say.

“Conversations and decisions about surgical interventions and their risks are never easy, but they’re even more difficult in emergency situations, and our study was designed to better understand — in a qualitative way — surgeons’ thought processes during these times,” says Fabian Johnston, M.D., M.H.S., assistant professor of surgery at the Johns Hopkins University School of Medicine. Few tools, he says, are available or demonstrated to be effective in objectively measuring these kinds of decisions.

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