Ethics Lecture Spotlights Reshaping of Surgery

A respected surgeon whose career spans over 4 decades—Mark C. Weissler, MD, FACS—will unravel the profound shifts in surgery that have quietly reshaped the profession in ways some may not have fully realized.

In the John J. Conley Ethics and Philosophy Lecture this morning, “Surgical Professionalism and Autonomy in the 21st Century” (9:45 am in Room 153 Upper Mezzanine South), Dr. Weissler will explain that for much of the previous century, surgeons operated under a moral framework built on trust. The surgeons promised knowledge, guaranteed competence, and altruistic service, in exchange for autonomy, self-regulation, and a monopoly over their knowledgebase. The contract was sacred—it defined what it meant to be a surgeon. But as he will describe, over time, this agreement has changed significantly.

“The moral contract that defined the profession of surgery in the 20th century no longer exists as we once knew it,” said Dr. Weissler, who is the retired former Joseph P. Riddle Distinguished Professor of Otolaryngology/Head and Neck Surgery and chief of the Division of Head and Neck Oncology at the University of North Carolina School of Medicine in Chapel Hill.

A key theme of the lecture will center around the loss of autonomy and the transfer of regulation to external entities. Regulatory bodies and health systems have increasingly taken control of the reins, leaving surgeons with less say over their own practices. Practicing altruism and morality in a system governed by external regulations can feel perilous and often involves navigating complex institutional demands that can conflict with the surgeons’ ethical obligations.

This shift, Dr. Weissler will argue, has resulted in “direct interference in the sanctity of the physician-patient relationship.” Many surgeons struggle with these changes, finding it difficult to align their practices with the traditional ideals they once upheld.

Speaking from personal experience, Dr. Weissler will share that his career—which began in the 1980s—spanned the turn of the century and offers a unique vantage point on the transformation. Over the years, he has witnessed a greater reliance on quality rather than morality in surgical practice. While the intention behind quality control is to ensure better patient outcomes, it can be a difficult and often vague concept to define.

Dr. Weissler will encourage “support for a new conceptualization of the profession,” while also calling on surgeons to redefine themselves in the 21st century—not as mere providers of a technical service, but as leaders who place morality at the forefront of their work, despite the challenges they face.

The John J. Conley Ethics and Philosophy Lecture, sponsored by the ACS Committee on Ethics, will be available for on-demand viewing shortly after the live presentation.