title: Where does innovation adaptation end and experimentation begin?
abstract: Dr U. Nique is internationally known for contributions in vascular surgery. An elderly man, a top governmental leader in his country, is in Dr Nique's clinic for evaluation of a recurrent complex thoracoabdominal aneurysm. It was treated inadequately by a vascular surgeon in another country and was redone without success. It still poses a threat to the man's life. Because of the unusual reconstructions, a one-of-a-kind repair is needed. Dr Nique has never done such a repair and, if someone else has, they have not published their results. What considerations should apply to this case?
authors.affiliation: The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Tex. Electronic address: jwjones@bcm.edu.
authors.forename: James W
authors.initials: JW
authors.lastname: Jones
authors.affiliation: The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Tex.
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D028744:Ethics Committees, Research; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent; D012107:Research Design; D014656:Vascular Surgical Procedures / Q000379:methods*