Black Natalie R, Winslade William J, Lindsey Ronald W, Gugala Zbigniew
Department of Orthopedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, Texas.
Institute for Bioethics and Health Humanities, University of Texas Medical Branch, Galveston, Texas.
J Bone Joint Surg Am. 2022 May 4;104(9):e37. doi: 10.2106/JBJS.21.00318. Epub 2021 Nov 18.
Orthopaedic hardware explantation is a multifaceted topic with complex legal, ethical, and scientific aspects that require thorough exploration. Issues of device ownership, explant-induced disease propagation, and potential device resale pose legal risks to providers and health-care institutions. Ethically, implant removal highlights the potential that performing procedures at the request of the patient will incentivize patient compliance and strengthen the patient-surgeon relationship. However, the return of explanted hardware to patients could hinder scientific study and innovation, ultimately limiting advancement in risk reduction and patient outcomes. Continued research into these topics remains paramount to ensure that clinicians and institutions deliver optimal patient care while abiding with legal and ethical imperatives. This article addresses the legal, ethical, and scientific issues that are pertinent to returning an explanted orthopaedic implant to the patient and the potential ramifications of such practice.
骨科植入物取出是一个多方面的话题，涉及复杂的法律、伦理和科学问题，需要深入探讨。器械所有权、取出引发的疾病传播以及器械潜在转售等问题给提供者和医疗机构带来法律风险。从伦理角度看，植入物取出凸显了应患者要求进行手术可能会激励患者依从性并加强医患关系的可能性。然而，将取出的植入物归还给患者可能会阻碍科学研究和创新，最终限制在降低风险和改善患者预后方面的进展。持续对这些话题进行研究对于确保临床医生和机构在遵守法律和伦理要求的同时提供最佳患者护理至关重要。本文探讨了与将取出的骨科植入物归还给患者相关的法律、伦理和科学问题以及这种做法的潜在影响。
