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April 1989

Advances in Neonatal Care

Author Affiliations

Department of Pediatrics Center for Medical Ethics University of Pittsburgh 3705 Fifth Avenue at De Soto Street Pittsburgh, Pa 15213-3417

Am J Dis Child. 1989;143(4):441. doi:10.1001/archpedi.1989.02150160063004

Sir.—Dr Goetzman's comments1 on neonatal care draw a false and disturbing distinction. By suggesting that innovation is, or should be, divorced from research, he encourages the introduction of unproved technologies into the clinical arena. Unfortunately, history teaches us that premature, that is, unvalidated, use of technology in practice may have disastrous consequences. We need not look hard to find examples of how inadequate testing of medical interventions has adversely affected the lives of children: thalidomide, radiation treatment of "enlarged" lymphoid structures, and exchange transfusion for Reye's syndrome come to mind quickly.

Like Dr Goetzman, I applaud the willingness of our medical and nursing colleagues to explore new approaches to vexing problems. Unlike him, however, I am wary of the entrepreneurial drive to rush new ideas into practice without serious scrutiny. In fact, it is our moral duty to prevent unnecessary harm that might arise from the unintended consequences

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