Abstract
Innovative practice occurs when a clinician provides something new, untested, or nonstandard to a patient in the course of
clinical care, rather than as part of a research study. Commentators have noted that patients engaged in innovative practice
are at significant risk of suffering harm, exploitation, or autonomy violations. By creating a pathway for harmful or nonbeneficial interventions to spread within medical practice without being subjected to rigorous scientific evaluation,
innovative practice poses similar risks to the wider community of patients and society as a whole. Given these concerns, how
should we control and oversee innovative practice, and in particular, how should we coordinate innovative practice and
clinical research? In this article, I argue that an ethical approach to overseeing innovative practice must encourage the early
transition to rigorous clinical research without delaying or deferring the development of beneficial innovations or violating
the autonomy rights of clinicians and their patients.