Abstract
You are the Chief of Vascular Surgery in a large community hospital that has been experiencing financial difficulties. Your division has been cited by the Utilization Review Committee for excessive lengths of stay in the ICU and hospital wards. After weeks of deliberations, with minimal input from surgeons, you are directed by the hospital Executive Committee to implement a fast-track clinical pathway for all patients undergoing major vascular procedures. Your staff surgeons believe that the data suggesting excessive lengths of stay are flawed and that the new directive may significantly increase postoperative morbidity and mortality. Your most responsible ethical action is which of the following?
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