Perspective: Future of Innovation in Neurosurgery

Abstract

Like any other professional healthcare provider, neurosurgeons have the moral obligation to act in the best interest of their patients. In addition, they have the responsible commitment to contribute toward generalizable knowledge that could potentially help improve outcomes for future patients. Therefore, it is of paramount importance to formulate ways to introduce novel procedures and devices at the highest ethical standards without stifling innovation. The use of predefined road maps—such as the one put forth by the IDEAL framework—is one possible way to introduce novel procedures and devices in neurosurgery in an ethically responsible manner, although it might not be possible for every type of innovation to adhere to this framework. Indeed, it remains a practical challenge to define what type of innovations warrant or demand safe and ethical introduction according to a framework like IDEAL. A potential solution might be the introduction of a so-called learning health system, in which knowledge generation is deeply embedded into the core of medical practice that it becomes a natural outgrowth and product of the healthcare delivery process itself and will thus lead to continual improvement in care. Even though a health system like this would require not only a separate ethics framework but also specific professional attitudes, it is my strong belief that the overall impact of such developments will foster and stimulate neurosurgical innovation, while minimizing the potential risks associated with blurring the traditional boundaries between research and care.