The proposal to extend clinical trials, which are routinely used as systematic tests of pharmaceutical innovations, to new surgical procedures should not be implemented. The point is that surgical procedures differ in one important respect from medicinal drugs: a correctly prescribed drug depends for its effectiveness only on the drug' s composition, whereas the effectiveness of even the most appropriate surgical procedure is transparently related to the skills of the surgeon who uses it. The reasoning in the argument is flawed because the argument ['describes a dissimilarity without citing any scientific evidence for the existence of that dissimilarity', 'ignores the possibility that the challenged proposal is deliberately crude in a way designed to elicit criticism to be used in refining the proposal', 'does not consider that new surgical procedures might be found to be intrinsically more harmful than the best treatment previously available', "assumes that a surgeon's skills remain unchanged throughout the surgeon's professional life"]