A surgeon's obligations when performing new procedures.

Abstract

A junior member of the vascular surgery faculty has done two robotic abdominal aneurysmectomies. Although he attended a standard 2-day training course conducted by the instrument manufacturer, performed several similar procedures in the animal laboratory, and read all the recent pertinent literature, technical errors resulted in significant morbidity in his first two patients. He proposes to use the technique once again on a hospitalized patient. His troubled chairman has called you for an opinion on whether an ethical question has now arisen. There are no specific credentialling standards for robotic surgery at this institution. Where might we most expect to see an ethical problem in the surgeon's management of the new case?