AAGL’s Newly Organized Ethics Committee

Ethics is a core requirement in all medical schools, so we are all familiar with basic principles – to one degree or another. As professionals, we are expected to adhere to a code of ethics – embodied by the AMA Code of Ethics^[1] and further developed through a wide array of articles and committee opinions – most notably those from the ACOG and ASRM Committees on Ethics. Add to this the plethora of media and articles surrounding ethical issues that arise in women’s health. In short, there are many voices clamoring to speak about issues related to our practice.

While AAGL has always had an ethics committee, the charge has not, as yet, been to publicly comment on issues but instead to address topics internally. With the recent ratification of our charter, our newly organized AAGL Ethics Committee will now have as its charge public comment by way of white papers published after appropriate board and peer review.

This could not come at a better time. We all currently face the global crisis of COVID19 and the incredible burden it puts on us as individuals and professionals. A clear example of ethics in practice is seen in AAGL’s excellent response joining other leaders in calling to postpone all elective surgical procedures.^[2]

The recommendation to hold all non-urgent surgical cases is an ethical rationing response to a global pandemic. It is not simply the OR space and personnel but also equipment and specifically gowns and masks that need to be conserved. Our essential personnel are currently restricting to one mask per day and in some cases trying to make their own PPE with scraps severely impacting their ability to safely care for patients. This shortage is presenting well ahead of others that are predicted including shortage of antibiotics, blood and anesthetics – all of which could potentially be used during elective cases. Thus, AAGL and its members have acted quickly and ethically to ration these scarce resources and protect our colleagues on the front lines. Of course, cancelling surgeries is a burden to patients who have been waiting months in some instances and must continue to wait.^[3] It is a severe burden financially to private and public programs large and small.  But it is still necessary and ethically required and we should be proud of the strong stance we have taken as professionals.

Our commitment to ethical practice is a cornerstone of our organization evidenced by our long history of prioritizing excellence in surgical care for women. As we eventually emerge from the current crisis – which we surely will – I welcome the opportunity as your Chair of the Ethics Committee to field topics for review along with my colleagues on the committee. Whether questions of surgical volume, appropriate surgical treatment of various conditions, scope of practice or any number of issues, ethics touches each aspect of our daily practice.

[1] https://www.ama-assn.org/topics/ama-code-medical-ethics

[2] https://www.acog.org/news/news-releases/2020/03/joint-statement-on-elective-surgeries

[3] https://www.theatlantic.com/science/archive/2020/03/patients-whose-surgeries-are-canceled-because-coronavirus/608176/