© 2019

Ethics of Innovation in Neurosurgery

  • Marike L. D. Broekman

Table of contents

  1. Front Matter
    Pages i-xviii
  2. Innovation in Neurosurgery: Key Ethical Challenges

    1. Front Matter
      Pages 1-1
    2. Mark M. Zaki, David J. Cote, Marike L. D. Broekman
      Pages 3-9
    3. Faith C. Robertson, Tiit Mathiesen, Marike L. D. Broekman
      Pages 11-25
    4. Ivo S. Muskens, Saksham Gupta, Alexander F. C. Hulsbergen, Wouter A. Moojen, Marike L. D. Broekman
      Pages 27-38
    5. Saksham Gupta, Ivo S. Muskens, Luis Bradley Fandino, Alexander F. C. Hulsbergen, Marike L. D. Broekman
      Pages 39-47
    6. Ludwike W. M. van Kalmthout, Ivo S. Muskens, Joseph P. Castlen, Nayan Lamba, Marike L. D. Broekman, Annelien L. Bredenoord
      Pages 49-56
    7. Bart Lutters, Eelco Hoving, Marike L. D. Broekman
      Pages 57-63
    8. Aislyn C. DiRisio, Ivo S. Muskens, David J. Cote, William B. Gormley, Timothy R. Smith, Wouter A. Moojen et al.
      Pages 65-74
    9. Joseph P. Castlen, David J. Cote, Marike L. D. Broekman
      Pages 75-82
  3. Payment for and Right to Innovation in Neurosurgery

  4. Evaluation of Innovations in Neurosurgery

    1. Front Matter
      Pages 119-119
    2. Saksham Gupta, Timothy R. Smith, Marike L. D. Broekman
      Pages 121-128
    3. Joeky T. Senders, Nicole Maher, Alexander F. C. Hulsbergen, Nayan Lamba, Annelien L. Bredenoord, Marike L. D. Broekman
      Pages 129-141
    4. Nayan Lamba, Marike L. D. Broekman
      Pages 143-150
  5. Innovation in Neurosurgery: Required Culture and Team Collaboration

    1. Front Matter
      Pages 151-151

About this book


This book covers all ethical aspects of introducing novel implants and procedures in neurosurgery in a structured way, addressing the current knowledge gap concerning ethical innovations in neurosurgery. Initially it explores the difficulties involved in defining when a procedure should be considered innovation, research, or care. To this end, it presents not only an overview of current literature, but also data from a recent survey among neurosurgeons in Europe.

The book subsequently discusses the ethical issues related to innovation. These include: informed consent (what should a surgeon tell the patient and how should he/she do so), oversight (can any surgeon simply implant a novel spinal device?), the learning curve (when should a surgeon be allowed to perform a novel procedure?), vulnerable patients (how to innovate in the pediatric population or in an emergency setting), and conflicts of interest, as well as the ethics of paying for innovative treatments.

In turn, the closing chapters focus on the evaluation of neurosurgical research and innovation. Are cultural changes necessary and how could innovation benefit from (international) collaborations? Given the range of topics addressed, the book offers neurosurgeons, residents, scientists, companies and hospital administrations a valuable guide to introducing novel implants and techniques in neurosurgery. 


Surgical innovation Research ethics Innovative treatments Clinical translation Learning health care system

Editors and affiliations

  • Marike L. D. Broekman
    • 1
  1. 1.Department of NeurosurgeryHaaglanden Medical Center & Leiden University Medical CenterThe Hague and LeidenThe Netherlands

About the editors

Marike Broekman, M.D. Ph.D. L.L.M. is a neurosurgeon with a focus on neuro-oncology at Haaglanden Medical Center/Leiden University Medical Center, the Netherlands and holds appointments at the Department of Neurology at Massachusetts General Hospital/ Harvard Medical School Boston, USA. Dr. Broekman is the principle investigator of a laboratory focusing on the development of innovative treatments and techniques for the diagnosis of brain tumors. She is the current president of the Ethico-Legal Committee of the European Association of Neurosurgical Societies and a member of the Ethics Committee of the World Association of Neurosurgical Societies. Dr. Broekman has published over 80 papers in peer-reviewed journals, and is a member of the editorial board of Acta Neurochirurgica.

Bibliographic information


“The book aims to facilitate the innovation process and provide both innovators and recipients of these innovation with proper ethical considerations. This subject is rarely discussed among neurosurgeons, making the book a valuable addition to every neurosurgeon's library. The goal of the authors and contributors is to educate neurosurgeons, neurosurgical trainees, researchers, and scientists, … . This book serves as an excellent primer.” (Konstantin V. Slavin, Doody's Book Reviews, July 12, 2019)