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Sleep, Health and SocietyFrom Aetiology to Public Health$
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Francesco P. Cappuccio, Michelle A. Miller, and Steven W. Lockley

Print publication date: 2010

Print ISBN-13: 9780199566594

Published to Oxford Scholarship Online: January 2011

DOI: 10.1093/acprof:oso/9780199566594.001.0001

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Ethical considerations for the scheduling of work in continuous operations: physicians in training as a case study

Ethical considerations for the scheduling of work in continuous operations: physicians in training as a case study

Chapter:
(p.435) Chapter 21 Ethical considerations for the scheduling of work in continuous operations: physicians in training as a case study
Source:
Sleep, Health and Society
Author(s):

C.A. Czeisler

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199566594.003.0021

One of the barriers that has repeatedly derailed attempts to address the issue of work-hour restrictions is the long hours worked by resident physicians during training. It is very difficult for specialists in occupational health — who champion workplace safety issues ranging from hearing protection to exposure to chemical carcinogens — to argue that sixteen-hour work shifts are hazardous when physicians routinely care for patients working twenty-four-hour shifts. Though a consolidated episode of ten hours of sleep restores performance to baseline levels for a few hours, those with a history of chronic sleep loss deteriorate much more rapidly as the number of consecutive hours of wakefulness increases, particularly overnight. Once physician work-hour reform has been implemented successfully in the United States, it will serve as the foundation for implementation of safer work schedules in a wide variety of industries.

Keywords:   resident physicians, junior doctors, chronic sleep loss, acute sleep loss, work-hour reform, wakefulness, occupational health, occupational injury, longer work hours, attentional failures

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