This paper examines the practice of ghost surgery — medical procedures performed by a physician other than the one contracted by the patient — and argues that it is ethically wrong when patients are not informed in advance. Drawing on two landmark legal cases, Tunkl v. Regents of the University of California (1963) and Shorter v. Drury (1985), the paper explores how informed consent and patient autonomy are central to medical ethics. While acknowledging that substitute practitioners are sometimes necessary for training purposes, the paper contends that patients retain the right to know who will perform their procedure before signing any release form.
The paper demonstrates effective use of legal case analysis to support an ethical argument. By contrasting Tunkl (where the patient signed under sedation and lacked true informed consent) with Shorter (where the patient made a fully informed, autonomous decision), the author illustrates that patient awareness — not merely a signed form — is the standard that matters ethically.
The paper opens by defining ghost surgery and establishing its scope across medical settings. It then introduces the central ethical claim: patients have a right to know who performs their procedure. Two legal cases are examined in sequence to test this claim from different angles. A brief counterargument regarding medical training is raised and rebutted, and the paper closes with a restatement of the thesis. The structure follows a classic argument-evidence-rebuttal-conclusion pattern suited to a short ethics essay.
The routine practice of ghost surgery is well documented in medicine. Ghost surgery refers to any medical procedure in which the contracting physician was not the actual physician who performed the procedure. In many instances, the patient is completely unaware simply because the patient is unconscious at the time. Ghost surgery is not, strictly speaking, limited to surgical procedures. The same phenomenon occurs in a variety of medical settings, from radiology to routine lab work.
In some instances, ghost surgery is a necessary component of the medical system — most obviously in the need to train medical students to become the future surgeons of the world. However, this practice becomes ethically problematic when the patient is unaware of what is happening, even if he or she has signed a release form that removes liability from the hospital and the physicians. Patients have a right to know who is performing their surgery or procedure before signing any release form.
Informed consent is a foundational principle of medical ethics. When a patient is sedated, in great pain, or otherwise incapacitated, he or she is not truly aware of what they are agreeing to. Medical centers should ensure that patients sign release forms before sedation, so that they are fully aware of what is happening to their body and the consequences of signing. The situation in which a patient unknowingly undergoes a procedure performed by a substitute physician is, in this sense, comparable to a patient signing a release form without understanding its contents.
The patient has the right to know that someone else will be performing the surgery, so that they may accept or decline accordingly. A patient may not wish to have a student operating on them. It is ethically wrong for a patient not to be fully informed before signing a release — and that includes being informed about the possibility of ghost surgery.
In the 1963 case Tunkl v. Regents of the University of California, Tunkl signed a release form while he was in pain and sedated, leaving him unaware of what he was signing. During his recovery at the medical center, he sustained injuries due to the neglect of two physicians. The court, however, ruled in favor of the Regents of the University of California, finding that Tunkl had signed a valid release (Quinbee, 1963).
Nevertheless, the ethical concern remains: a patient who is sedated and in great pain is not in a position to give meaningful, informed consent. The medical center should have allowed Tunkl to sign the release form before sedation, when he would have been fully aware of the consequences. This case illustrates a broader problem — a signed form does not necessarily equal true informed consent, particularly when the signing occurs under conditions that compromise the patient's understanding.
In contrast, in Shorter v. Drury (1985), the patient was fully aware of the consequences of her procedure. She knew that it carried a significant risk of major blood loss and that she would likely need blood transfusions to recover. She refused to authorize the physician to administer blood if she needed it. Unfortunately, she died because the physician was unable to give her blood (Quinbee, 1985).
Even though ghost surgery is a necessary component of the medical system for training future physicians, it is ethically wrong when conducted without the patient's knowledge. It is wrong because the patient is unaware of what is happening, even if he or she has signed a release form. As illustrated by the contrast between Tunkl and Shorter, a signature alone does not constitute meaningful consent. Every patient has the right to know who is performing their surgery and to make an informed decision before any procedure begins.
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