Ethics of surgical innovation for congenital heart diseases

This chapter explores the nature of surgical and medical innovation and considers the ethical principles that guide the moral application of innovation to patient populations. Historical milestones are discussed that have resulted in significant innovation in thoracic and cardiovascular surgery that has resulted in the development of the heart-lung machine, open heart surgery, the intensive care unit, myocardial protection strategies as well as countless new operations, modified procedures, and new devices. Historical annotations and careful review of these innovations show that most of these advances were not considered casually and were not impromptu ideas applied haphazardly by surgeons who were seeking acclaim, promotion, or monetary gain. Ethical issues are discussed with regard to regulation of surgical innovation, moral duty, rational discussion, introduction of innovation into, and future considerations. Throughout the chapter are rich historical anecdotes that have framed and highlighted the history of surgical innovation.