Surgery News - May 2008 - (Page 18)

18 ETHICS THE RIGHT CHOICE SURGERY NEWS • M AY 2 0 0 8 Patenting Surgical Procedures Editor’s note: The following article is a condensed version of an article that was originally published in the Journal of Vascular Surgery (Jones, J.W.; McCullough, L.B.; Richman, B.W. 2003;37:235-6). “Reputation is what other people know about you. Honor is what you know about yourself.” —L.M. Bujold, “A Civil Campaign” (Baen Books: Riverdale, N.Y., 1999) r. A. Droit has developed an office procedure that can permanently repair hiatal hernias—an easily mastered technique that uses a tissue adhesive already on the market. After devoting years to the project, he is now considering patenting the procedure and realizing a return for his efforts. What should he do? A) Publish his discovery and share it freely among fellow surgeons. B) Patent the procedure as he is entitled D to do, and receive compensation. C) Patent the idea but, to be ethical, donate a portion of the royalties to charity. D) Patent the glue used by disguising it. E) Form a company of his own and have the company patent the operation. In the late 18th century, physician-ethicists argued that the physician should be the patients’ fiduciary, dedicated to the protection of patients’ health and only secondarily to his or her own self-interest. New from the American College of Surgeons and Thomson Healthcare I Need an Operation Now What? A Patient’s Guide to a Safe and Successful Outcome I Need an Operation…Now What? gives patients the information they need to boost their chances of having a successful surgical experience, with the best possible results. Written in patient-friendly, nontechnical language, this book is designed to help patients understand the process of having an operation from start to finish. Inside they’ll learn: » How to find a qualified surgeon—one who’s right for them » When to get a second opinion about their treatment—and how to go about finding one » How to ask about the risks and benefits of having an operation » How to prepare for an operation—from what to pack and what to wear to when to stop eating » What to expect, including advice from patients who’ve had various operations, from major gastrointestinal procedures to back surgery—and who will care for them—while in the hospital » Numerous "insider's" tips, such as how to help prevent infection and the best times to schedule an operation » All the costs of the operation » How to ensure a comfortable recovery period The experts agree “Along with your love and support, the greatest gift you can give a loved one or friend facing or weighing the beneﬁts and risks of surgery is a copy of this book. With his thoughtful, clear, very accessible writing, Dr. Russell, with the American College of Surgeons, provides a wealth of informational resources that every patient can draw on. He gives excellent advice on how to ask good questions and become an informed, empowered consumer. Most importantly, he urges you, the patient, to ‘take control and become fully informed about your options.’ This book will help you do that, prepare you for the effects of surgery and how to deal with them and give you conﬁdence as you navigate through the health care system.” Helen Darling, president of the ISBN 13: 978156363-700-1 Pub. Jan 2008 • Paperback $19.95 • 125 pp National Business Group on Health “Like a true professional, Dr. Russell gives surgical patients-to-be all the information and support needed to make decisions that meet their needs as only they can know them. This book is not only practical, but also highly respectful, most educational. Patients can use this book to navigate through their surgical experience while we all push for a better-organized health care delivery system.” Richard J. Umbdenstock, president and CEO of the American Hospital Association “Research shows that people who are well informed about their treatment options enjoy better surgical outcomes and are more satisfied with their results.” Consistent with this professional ideal, the Council on Ethical and Judicial Affairs (CEJA) of the American Medical Association advanced a detailed argument against patenting surgical procedures, noting that the practice would likely promote self-interest, limit access to care, inhibit the development of new medical procedures, shield “trade secrets” from peer review, and increase the cost of medical care (Food Drug Law J. 1998;53:341-57). For centuries, surgical information has been shared with all in the profession, regardless of the financial impact on the teacher. The goal of surgical education is to extend human life and health, upon which no one can fix a price. A better-constructed cabinet brings a higher price at market, but the artisan who made it is not obligated to teach his colleagues, or to advance the art and function of cabiBY JAMES W. JONES, M.D., netry. The surPH.D., FACS geon, however, is obliged not only to practice well, but to teach and broaden the principles of medicine. Ideally, surgeons try to disseminate knowledge across specialties such that a collective professional consciousness is developed, within which information and wisdom are shared across generations. The cost of dissemination is distributed in almost every part of the world, with only a small fraction borne by the trainee. The inclusionary nature of surgical education is intended to make therapeutic methodology rapidly accessible to physicians. Patents are by their nature exclusionary, intended to allow access to essential knowledge only by paying customers and enriching the patent holder. The United States is one of the few highly developed countries that allow surgical procedures to be patented. Yet holders of surgical patents violate the sacred traditions of surgery by using its accumulated body of knowledge to advance their prospects, not their profession. So, which option is best for the surgeon-inventor? Concerns about antiprofessionalism cancel option B. Donating some of the royalties to charity does not mitigate any of CEJA’s objections, so option C is out. Option D involves an illegal deception. Forming a new company is intended to disguise him and limit his liability; it compounds rather than eliminates the moral baseness. That leaves option E, which is ethically insupportable. Among all of surgery’s accomplishments, the selfless cooperation of countless surgeons over two and a half millennia to relieve human suffering stands as its proudest achievement. DR. JONES is a visiting professor at the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, and an ACS Fellow (jwjones@bcm.tmc.edu). To order or for further information visit http://www.facs.org/public_info/patientguidebook.html or call 312/202-5474 http://www.facs.org/public_info/patientguidebook.html

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Surgery News - May 2008 Contents New Lung Approach Speeds Extubation Innovative GI Procedures May Improve Diabetes Quality Programs Differ on Risk Data Crystal Ball Medical Modeling Ventricular Valve Taking Stock

Surgery News - May 2008

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