ince 1998, members of the Committee on Ethics have been composing, editing and publishing a resource guide particularly designed for anesthesiologists on clinical ethical issues. The syllabus currently is available as a downloadable PDF file on the ASA Web site <www.ASAhq.org> by clicking on “Publications and Services” then “General Publications” and finally “Syllabus on Ethics.”

The syllabus now consists of some 150 pages of background materials, annotated references and clinical cases with discussion outlines. It is intended to be a learning and teaching guide for anesthesiologists to use to become more informed about common ethical issues. Recommendations for further resources and suggested readings are liberally given under every topic.

The topics included so far are discussions and practical information concerning informed consent, pediatric consent, informed refusal of recommended care, substituted consent situations, end-of-life care, resuscitation limitations during anesthesia care, medical futility/withdrawal of nonbeneficial care and organ donation after brain death. The most recent additions to the syllabus are chapters about professional relationships in medicine, including conflicts, communication difficulties, sexual harassment and student-teacher relationships. All of these issues are now included in the required education and preparation of resident physicians but were not mandated or formal parts of the education of most practicing anesthesiologists.

Many other specialty societies also have developed resources that translate current bioethical understandings into the context of practical cases within their own specialties. In order to understand and abide by current ethical expectations of all physicians, it is important for anesthesiologists to further educate themselves on ethical issues as part of their continuing educational efforts. The main focus of the development of medical ethics since the 1960s has been the placement of the patient at the center of medical decision-making. All physicians are expected to guide, empower and respect patients who want to make informed decisions about their own care.

The Committee on Ethics considers adding new topics to the syllabus as they are suggested by ASA members or as national issues arise within our specialty. The committee welcomes suggestions from all ASA members on topics that they feel should be addressed in the context of the practice of anesthesiology. Please feel free to contact any member of the Committee on Ethics to voice your concerns or to suggest an issue that should be addressed.

Susan K. Palmer, M.D., is Staff Anesthesiologist, Oregon Anesthesiology Group, Salem Hospital, Salem, Oregon.