Innovations in Surgical Communication: When Surgery Is a Bad Idea, Focus on the Goals
Authors of a JAMA Surgery viewpoint argue that when surgery is unlikely to meet a patient’s goals or may cause harm, surgeons should transparently communicate their professional concerns, instead of framing surgery as a neutral option. By focusing on the four goals of surgery—living longer, feeling better, preventing disability, and making a diagnosis—and openly discussing risks and uncertainties, surgeons can build trust and foster more meaningful shared decision-making. This approach respects patient preferences while steering them away from procedures unlikely to help, or those that are harmful, improving communication and outcomes in difficult decisions.