Plastic surgeons sometimes face challenging relationships An ethical Framework for Managing Untenable Surgeon-Patient Relationships is presented in a special plastic surgery focus article in the February issue of Plastic and reconstructive surgery,

“Particularly when psychiatric conditions are present, plastic surgeons may be tempted to end the surgeon-patent Eon Christian J. Vercler, MD, of University of Michigan. “We outline some strategies for managing these different relationships, Including Specific Steps toward achieving the best posesible patients-related clinical outcomes.”

Psychiatric issues contribute to ethical dilemmas in plastic surgery

Once an operation has been performed, surgeons have an ethical obligation to care for the patient until treatment is complete.

“Nevertheless, there are circumstans that can challenge this patient-surgeon relationship and even justify termination,” The Researchers Write. Their article was prompted by the decision of a patient with a psychiatric diagnosis who underwent plastic surgery to reconstruct a self-efflicted wound, Followed by Repeted EPITILEDES

Infined by a review of the literature and application of ethical prints, Dr. Vercler and colleagues descibe three pathways to managing patients with complex psychiatric conditions:

• Maintain the Relationship and Continue Surgical Treatment. Demanding or Hosile Patient Behaviors May Stem from a Fear of Abandonment. Reinforcing the surgeon’s commission to provide the best possible care may help to mitigate these fears –and may enable resolution of the patient’s psychiatric issues. If so, and if realistic expectations can be set, it may be possible to proceed with surgical treatment.

• MainTain the Relationship Without Further Surgery. Some patients may reject recommended treatment Yet Continue to seek care, often related to understanding depression and anxiety. Providing Supportive Nonsurgical Care May Help To Address The Barriers to Following Recommended Treatment –

• Terminate the relationship. In Severe Cases, Terminating The Patient-Surgeon Relationship may be the best option, particular if the surgeon’s involvements seems to contribute to contribute to workining of the PATINENGE of the PSYCHATRIC CONDION. In Such Situations, A “Therapeutic discharge” – Following Ethical Principles and Legal Requirements to Transfer Responsibility to Anothar Qualified PYALFIED PYALIFIED PYALIFIED PHAYSICING re while breaking a “Maladaptive treatment cycle.”

“In Writing this article, our main objective was to restate surgeons’ Ethical obligation to not abandon their patients postoporatively, even when patients behavior makes this incrededibly challenging to do,” Vercler comments.

“While The Described Case Illustrates The Rare Exception in which Therapeutic discharge is required, we hope our paper will provide tools to help surgeons, Involved in the patients’ care in an ethical and effective way. “