Introduction & Objective: Operating room (OR), is an isolated, secured, specialized and Holy
environment in which, surgical patients are accepted, operated, and managed with highest dignity, respect and
compassion. Ethical and professional issues pertaining to anesthesia, surgery, and optimal care of patients at OR, are
unique, critical and controversial. Defining, approving and application of surgical codes of ethics, professional
principles and moral values is mandatory in situations specific to OR. Unethical and unprofessional behavior, in any
form or by any means, is forbidden by all members of OR team. This article reviews these priciples with respect to all
pertinent processes in OR during the preoperative, intraoperative, postoperative periods.
Materials & Methods: The study designed and conducted by an expert group of ethics committee of Iranian
Surgical Association and were further enhanced by internal and external experts. Lists of relevant ethical issues were
developed by literature review of recent 3 decades, and ordered in main categories by focus group discussion.
Fundamental ethical and professional principles, accepted and preferential moral values, and unethical behaviors,
were established and arranged in order of priority.
Results: We identified 14 main categories of fundamental ethical and professional principles, 237 preferential
issues, and several important sub-topics. Main categories are as below:
1. OR ethics organizational structure
2. Fundamental ethical principles and moral values
3. Fundamental ethical practice of anesthesiology in OR
4. Fundamental surgical ethics in OR
5. Interprofessional collaboration and communication in OR
6. Surgeons and Anesthesiologists common ethical and professional responsibilities in OR
7. Ethical and professional responsibilities of OR nursing
8. Technician duties and and professional ethical responsibilities in OR
9. Standards of practice, Legal and Professional aspects of OR duties
10. OR safety and guideline of safe surgery: ethical and professional obligations
11.OR conflicts: roots, prevention, mamagement strategies and instant value-based resolution
12.Ethical principles special to residency education at OR
13.Principles of ethical and professional cpnduct in different surgical disciplines
14.Ethical aspects of surgical research at OR
Each main category followed by a list of relevant, specialized codes, ethical principles, moral values, professional
regulations, or other topics, and was concluded at discussion section of the article.
Conclusions: Recognition and regard the principles of surgical ethics and professionalism have become a
central area of attention by Iranian Surgical Association. This study is a guide to widely accepted recommendations,
applicable in anesthesiology, general surgery, nursing, technicians, and various other surgical and anesthesiology
disciplines, as well as other OR team members.