{"id":4799,"date":"2026-08-06T03:36:39","date_gmt":"2026-08-06T02:36:39","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4799"},"modified":"2026-08-06T03:36:39","modified_gmt":"2026-08-06T02:36:39","slug":"spontaneous-surgical-innovations","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2026\/08\/06\/spontaneous-surgical-innovations\/","title":{"rendered":"Spontaneous surgical innovations"},"content":{"rendered":"

By Isabella Grace Carnovale<\/p>\n

Suppose your loved one is having a routine surgical procedure, and something goes wrong. The
\nsurgeon could try an innovative technique to save them, but does not know whether it will work,
\nor what the long-term side-effects of the innovation might be. Is it right for the surgeon to
\ninnovate in this situation? And what moral obligations do they have if they do?<\/p>\n

A lot of work has been done exploring the ethical implications of surgical innovation, but almost
\nnone of this work focuses on unplanned innovations that aim to solve problems that arise during
\nsurgery. Almost exclusively, bioethicists discuss how surgeons best navigate the period before a
\nplanned surgical innovation (e.g., how informed consent should be carried out).<\/p>\n

However, surgical innovation can happen without prior planning. A problem might occur during a
\nsurgery that has no standard resolution. In these cases, surgeons might need to innovate to save
\ntheir patient. I call this \u201cspontaneous surgical innovation\u201d.<\/p>\n

Spontaneous surgical innovations raise unique ethical challenges. Patients can\u2019t give pre-operative
\ninformed consent for spontaneous innovations like they can for planned innovations. And questions
\nof liability are complex: if a surgeon has to innovate to save their patient, but the patient is harmed
\nor even dies as a result of the innovation, it\u2019s unclear if we should hold them accountable. We don\u2019t
\nwant surgeons to feel as though they can\u2019t try everything to save a patient, but we also don\u2019t want
\nsurgeries where \u201canything goes\u201d.<\/p>\n

Judging the decision to innovate without prior planning is a difficult task, especially given how
\ncontext dependent these kinds of on-the-spot choices are. Assigning accountability requires us to
\nknow more about what kinds of intraoperative events make spontaneous innovations permissible,
\nand whether surgeons are ever obligated to innovate in specific contexts.<\/p>\n

Spontaneous innovations can generate valuable knowledge. Given their context (responses to
\nintraoperative events), spontaneous innovations give us insight into surgical approaches that we
\nmight not get otherwise. We might then want to consider whether surgeons have a duty to share
\ntheir innovations with the broader surgical community.<\/p>\n

Unlike spontaneous innovations, planned innovations are carried out in the context of research and
\nwith broader sharing already in mind. It will be difficult to carry out research or trials on the kinds of
\ninnovations we might see with SSI given that they occur in response to unpredictable intraoperative
\nevents. As such, when spontaneous innovation does occur, any knowledge gained will be significant
\nand this creates an obligation of the surgeon to share this knowledge.<\/p>\n

In this paper, I introduce spontaneous surgical innovations as a distinct kind of innovation that needs
\nto be explored independently of planned innovations. I discuss some real case examples and some
\npotential starting points for approaching some of the challenges mentioned here. Until now,
\nspontaneous surgical innovation has been looked over and its ethical implications left unexplored
\nand unaddressed. My hope with this paper is to show that spontaneous surgical innovation conjures
\nup a number of both ethical and epistemic challenges and that both patients and surgeons will
\nbenefit from a better understanding of SSI.<\/p>\n

Paper title<\/strong>: Spontaneous Surgical Innovation<\/a><\/p>\n

Author<\/strong>: Isabella Carnovale<\/p>\n

Affiliations<\/strong>: Macquarie University<\/p>\n

Competing interests<\/strong>: N\/A<\/p>\n

Social media<\/strong>: LinkedIn;<\/a> PhilPeople<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

By Isabella Grace Carnovale Suppose your loved one is having a routine surgical procedure, and something goes wrong. The surgeon could try an innovative technique to save them, but does not know whether it will work, or what the long-term side-effects of the innovation might be. Is it right for the surgeon to innovate in […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":522,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[968,8057],"tags":[],"class_list":["post-4799","post","type-post","status-publish","format-standard","hentry","category-clinical-ethics","category-medical-ethics"],"yoast_head":"\nSpontaneous surgical innovations - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2026\/08\/06\/spontaneous-surgical-innovations\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Spontaneous surgical innovations - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Isabella Grace Carnovale Suppose your loved one is having a routine surgical procedure, and something goes wrong. 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