The ethics of surgical research and innovation

Wendy A. Rogers*, Katrina Hutchison

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Surgical advances can provide great benefits to patients but can come at a cost. The successes are often matched by failures that cause harm to patients. The risks of surgery create a strong ethical imperative for research to establish the safety and efficacy of new treatments. Surgical research is, however, challenging for a number of reasons including the lack of a clear boundary between variations in practice, innovation and research, its irreversible nature, the difficulty of performing placebo-controlled randomised trials, confounding factors such as surgeon learning curves and conflicts of interest. In this chapter the ethical issues raised by surgical innovation are explored with the use of a case study based on the uptake of vaginal mesh to treat vaginal prolapse to highlight these issues (Sects. 12.1 and 12.2). In Sect. 12.3 the argument for the value of a structured approach to introducing innovations, such as that developed by the IDEAL Collaboration, which clarifies both ethical and methodological issues at each stage of research is proposed. This chapter recognises that ethical challenges extend beyond adequate ethical evaluation of the innovation in the care of individual patients to include broader issues such as justice in access to any new interventions.

Original languageEnglish
Title of host publicationMedical research ethics
Subtitle of host publicationchallenges in the 21st century
EditorsTomas Zima, David N. Weisstaub
Place of PublicationCham, Switzerland
PublisherSpringer, Springer Nature
Number of pages16
ISBN (Electronic)9783031126925
ISBN (Print)9783031126918
Publication statusPublished - 2023

Publication series

NamePhilosophy and Medicine
ISSN (Print)0376-7418
ISSN (Electronic)2215-0080


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