The ethics of surgical innovation: more than one answer?

Ethics Oversight Mechanisms for Surgical Innovation: A Systematic and Comparative Review of Arguments

Surgical innovation typically falls under the purview of neither conventional clinical ethics nor research ethics. Due to a lack of oversight for surgical innovation-combined with a potential for significant risk-a wide range of arguments has been advanced in the literature to support or undermine various oversight mechanisms. To scrutinize the argumentation surrounding oversight options, we conducted a systematic review of published arguments. We found that the arguments are typically grounded in common sense and speculation instead of evidence. Presently, the justification or superiority for any single oversight mechanism for surgical innovation cannot be established convincingly. We suggest ways to improve the argument-based literature and discuss the value of systematic reviews of arguments and reasons.

Seeing Through the Lies: Surgical Innovation and the Need for Transparency

The Robert E Gross Lecture was delivered by Professor Martin Elliott of London, at Boston Children's Hospital June 1st, 2016. Professor Elliott makes a plea for revision to the system of medical publication and academic reward, especially in the field of surgery.

Disclosure, consent, and the exercise of patient autonomy in surgical innovation: a systematic content analysis of the conceptual literature

The classification of surgical innovation as clinical care, research, or as third distinct type of activity creates ambiguity which impacts standards for disclosure and informed consent. We conducted a systematic review of the conceptual literature to identify positions expressed about consent and disclosure, as well as major tension points associated with this issue. Literature overwhelmingly favors special consent and disclosure. Four major tension points were identified: the use of biasing/biased terminology to characterize innovation; patient vulnerability; the relationship between surgeon-innovator and patient; and practices and associated gaps related to consent and disclosure. Recommendations often focused on the informed consent process.