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Surgical innovation is a major driver of progress in neurosurgery. While clinical ethics and research ethics are well-defined, there is limited knowledge about sound ethics of surgical innovation. Here, we discuss different ethical aspects of innovation, including oversight, conflicts of interest, the surgical learning curve, introducing surgical devices, informed consent, and vulnerable patient populations. A robust ethical framework can empower surgeons to innovate in a way that both protects patients and advances the neurosurgical discipline.
We describe an ethical framework for the surgical treatment of brain tumour patients, specifically for the treating surgeon, the researcher, and with a special emphasis on end-of-life decision making. Different ethical axes are systematically described, integrated and illustrated with case discussions.
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