Surgery has 3 E's: Emergency, Elective, Experimental. Emergency Surgery focuses on providing immediate care to the most at risk patients. It is executed in cases of acute threats to life through crucial organs, limbs, and tissue. These injuries can be derived through ‘external trauma, acute disease process, acute exacerbation of a chronic disease process, or complication of a surgical or other interventional procedure’(UEMS Section of Surgery, n.d.). These surgeries are performed regardless of the patient’s conscious state and ability to provide consent. Elective surgery entails the idea of non-emergent surgical operations. These can be scheduled in advance, and include, though are not limited to cosmetic surgeries along with organ donation procedures.

Experimental surgeries are generally conducted on animals, however, there is research directed by doctors in the form of clinical trials. These clinical trials are approved by an ethics board to ensure a certain integrity and moral code. Various fields are being researched through clinical trials, including robot-assisted surgeries, cancer therapy, neurological disorders, etc... Such procedures may appear to be beneficial, though perspectives differ. This article will discuss the positive and negative aspects and the range of perspectives regarding them.

Emergency Surgery occurs in the case of extreme accidents, disease and complications of alternative surgery procedures. The most common example of emergency surgery is trauma surgery in which the patient sustains severe injury throughout the body. However, trauma surgery also takes place in cases such as acute appendicitis (the patient has a dangerously inflamed appendix, and can result in the rupture of the appendix), which occurs more frequently due to late discovery. The main ethical debate regarding emergency surgery is centred around consent and unconscious patients. In certain trauma cases and other situations, the patients are unable to verify whether they would opt for the surgery they undergo. Therefore, family members would generally be contacted to confirm the surgeons. However, this is not applicable in every circumstance. Several people believe that regardless of whether consent is provided or not, the patient should be saved as it would be unethical for surgeons to simply ‘watch the patient die’.  A contrasting portion of people may debate that depending on the scale of the injuries a patient may not have the will to live. In addition, if family members are unreachable, the hospital is also unaware of the patient’s financial status and whether they can afford the surgery that condition they may undergo.

Elective surgeries are generally related to non-emergent conditions. They are essential to maintain a patient's lifestyle however the symptoms are not directly a threat to their life. For instance, plastic surgery regarding categories of cosmetics, removing a wart or mole, and even a hip replacement may qualify for such a procedure. Though, according to statistics from Perioperative Medicine in 2023, developing countries reported a 1.2% mortality rate for elective surgery. There are 2 ethically motivated discussions concerning elective surgeries. Firstly, as these surgeries are not always required, patients may take inessential risks for a surgery that may not be health-related. An example of this is eye colour surgery, which is described as the ‘most dangerous cosmetic procedure’(MedEsthetics, 2024), and has a complication incidence of over 90%,  Secondly, since the healthcare system is a hectic environment, it’s a complicated process for surgeons to allocate operation rooms for the various surgeries that must be performed. In this case, many find it unethical for an elective surgery to be prioritised over an emergency surgery. However, now that emergency surgery is prioritised since they are critical injuries that challenge the bridge between life and death, those with elective surgeries may find it unjustified to postpone bettering their quality of life.

Experimental surgeries are conducted under the category of clinical trials. A clinical trial is a research-based investigation that practises new medical procedures on humans to test the functionality of the theory. A specific example of this can be seen through a clinical trial conducted at Sun Yat-sen University, China. They analysed the Intraocular Lens-shell Technique in Phacoemulsification, which is a surgery where a cataractous lens could be emulsified and an intraocular lens (IOL)  could be deposited to provide enhanced visualisation. The study was divided into 2 groups, Group I: IOL was traditionally implanted…Group II, IOL was innovatively implanted …(Lin, H., 2014) This study eventually resulted in a detailed comparison that allowed them to gain a deeper understanding of  Intraocular Lens-shell Technique in Phacoemulsification. Though all clinical trials undergo an ethical review before the investigation, it can be argued that this is unethical as humans may be subjected to serious complications. Others may argue that the research could potentially be life-altering and improve their lives as well as those of others who suffer from the same conditions.

In conclusion, Emergency, Elective and Experimental surgeries are crucial to medicine and have an explicit impact on it. Though it could be debated that the viability of some over others, though each is equally important as it has played a huge role in the evolution of surgery and benefited human life.

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