Book contents
- Frontmatter
- Contents
- List of contributors
- Acknowledgements
- 1 Introduction
- Section I Information problems
- Section II End of life care
- Section III Pregnant women and children
- Section IV Genetics and biotechnology
- Section V Research ethics
- Introduction
- 25 Research ethics
- 26 Innovation in medical care: examples from surgery
- 27 Clinical trials
- 28 Epidemiological research
- 29 Clinical research and the physician–patient relationship: the dual roles of physician and researcher
- 30 Financial conflict of interest in medical research
- 31 Embryo and fetal research
- Section VI Health systems and institutions
- Section VII Using clinical ethics to make an impact in healthcare
- Section VIII Global health ethics
- Section IX Religious and cultural perspectives in bioethics
- Section X Specialty bioethics
- Index
- References
26 - Innovation in medical care: examples from surgery
Published online by Cambridge University Press: 30 October 2009
- Frontmatter
- Contents
- List of contributors
- Acknowledgements
- 1 Introduction
- Section I Information problems
- Section II End of life care
- Section III Pregnant women and children
- Section IV Genetics and biotechnology
- Section V Research ethics
- Introduction
- 25 Research ethics
- 26 Innovation in medical care: examples from surgery
- 27 Clinical trials
- 28 Epidemiological research
- 29 Clinical research and the physician–patient relationship: the dual roles of physician and researcher
- 30 Financial conflict of interest in medical research
- 31 Embryo and fetal research
- Section VI Health systems and institutions
- Section VII Using clinical ethics to make an impact in healthcare
- Section VIII Global health ethics
- Section IX Religious and cultural perspectives in bioethics
- Section X Specialty bioethics
- Index
- References
Summary
C, a newborn infant, develops persistent vomiting on the second day of life. X-rays show midgut volvulus, a condition in which the intestines have twisted around their blood supply. Surgical exploration reveals necrosis of all but 15 cm of his small bowel. The necrotic bowel is removed and total parenteral nutrition (TPN) is initiated. At one year of age, he is taking half of his nutritional needs through his intestinal tract; the other half is given intravenously. Blood chemistry tests show that he is starting to develop significant liver damage from the TPN. C's remaining small bowel has become dilated and dysfunctional. You have recently read about a new operation called the serial tapering enteroplasty (STEP), an innovative technique, which may be able to lengthen the remaining intestine and permit it to function more effectively. A surgical stapler in common use is deployed to segment the dilated bowel into a tapered, lengthened tube more closely resembling the shape of the small intestine (Kim et al., 2003). This operation, first developed in dogs, has been undertaken in a small number of infants with short bowel syndrome. It is considered a non-validated innovation by most pediatric surgeons and is not yet accepted as part of standard surgical practice. You would like to offer the procedure to your patient, but you do not think that there is time to go through the full Research Ethics Board approval process at your hospital. Your intention is to try to help, and perhaps other patients like him.[…]
- Type
- Chapter
- Information
- The Cambridge Textbook of Bioethics , pp. 194 - 200Publisher: Cambridge University PressPrint publication year: 2008