Cardiovascular medicine is a data-driven field informed by large randomized clinical trials and clinical registries that shape daily practice and improve the quality of care worldwide. Cardiovascular specialists are used to applying evidence to guide our use of medications, tests, and procedures. We have many therapeutic options at our disposal, and there are lots of things we can do. By contrast, the field of medical ethics incorporates theoretical and empirical methods to help us determine what we ought to do with these extraordinary tools. While medical trainees receive basic training in ethical principles and terminology, by the time cardiovascular specialists are in practice, many may view ethical analysis as an esoteric practice of mental gymnastics rather than clinically relevant. Prior discussions of the intersection of cardiology and bioethics have observed that “cardiology journals and textbooks contained the fewest references to ethical issues of any medical subspecialty.”^1–3 The paucity of ethical inquiry in cardiology represents an opportunity for positive change. With the growing complexity of cardiovascular care and therapeutic options, cardiovascular specialists must think beyond hard data. If we are to provide high-value care for our patients, we must be more curious about facing the shades of gray—just because we can do something does not mean that we ought to do it.

Circulation: Cardiovascular Quality and Outcomes takes this charge seriously. Historically, many clinicians have conflated ethics writing with opinion pieces. This is not the case. Our goal is to help practitioners better understand the discipline and methods of ethical inquiry and its applicability in routine clinical practice. In this spirit, we are introducing a series of pieces from invited experts in the field focused on both normative (ie, how people ought to behave) and descriptive (ie, how people behave and how they think they should behave) ethics, using examples from a variety of ethical controversies in contemporary cardiology. Our goal through this series of articles is to demonstrate how ethics can be both practical and essential in clinical decision-making. These topics align with the core values of our journal and our focus on what practitioners ought to do in the service of patients and public health.

We are excited to introduce this medical ethics series with a piece focusing on the ethical complexity associated with research and clinical management of patients living with heart failure. Future issues will include ethics-focused inquiry pertaining to pragmatic clinical trials, artificial intelligence, data sharing, cardiac transplantation, and social determinants of health. We hope this series will encourage the cardiovascular community to rally behind practical clinical ethics, as well as increase our understanding of different perspectives, principles, and values that should guide us.

The field of cardiology has always been a leader in data and evidence-based medicine. Given the medical complexity of our field, we should not be the subspecialty with the lowest references to medical ethics. This series is our journal’s push to help recognize and navigate the medical gray zones of our field and make practitioners more facile with applying medical ethics in real-world decision-making.

Disclosures None.

The opinions expressed in this article are not necessarily those of the American Heart Association.

For Disclosures, see page 102.

心血管医学是一个数据驱动的领域，以大型随机临床试验和临床登记为基础，塑造日常实践并提高全球护理质量。心血管专家习惯于应用证据来指导我们使用药物、测试和程序。我们有许多治疗选择可供选择，而且我们可以做很多事情。相比之下，医学伦理学领域结合了理论和实证方法来帮助我们确定应该如何使用这些非凡的工具。虽然医学实习生接受了伦理原则和术语方面的基本培训，但当心血管专家开始实践时，许多人可能会将伦理分析视为一种深奥的心理体操实践，而不是与临床相关。先前对心脏病学和生物伦理学交叉的讨论发现，“心脏病学期刊和教科书对任何医学亚专业的伦理问题的提及最少。” ^1-3心脏病学中伦理探究的缺乏代表着积极变革的机会。随着心血管护理和治疗方案日益复杂，心血管专家的思考必须超越硬数据。如果我们要为患者提供高价值的护理，我们必须对面对灰色地带更加好奇——仅仅因为我们可以做某事并不意味着我们应该这样做。

循环：心血管质量和结果严肃对待这一指控。从历史上看，许多临床医生将伦理写作与观点文章混为一谈。不是这种情况。我们的目标是帮助从业者更好地理解伦理探究的学科和方法及其在日常临床实践中的适用性。本着这种精神，我们将通过示例介绍一系列来自该领域的特邀专家的文章，重点关注规范性（即人们应该如何行为）和描述性（即人们如何行为以及他们认为自己应该如何行为）伦理学来自当代心脏病学的各种伦理争议。我们通过这一系列文章的目标是展示道德如何在临床决策中既实用又重要。这些主题与我们期刊的核心价值观以及我们对从业者应该为患者和公共卫生服务的关注点相一致。

我们很高兴推出这个医学伦理系列，其中一篇文章重点关注与心力衰竭患者的研究和临床管理相关的伦理复杂性。未来的问题将包括与实用临床试验、人工智能、数据共享、心脏移植和健康社会决定因素有关的以伦理为中心的调查。我们希望这个系列能够鼓励心血管界团结起来支持实用的临床伦理，并增加我们对指导我们的不同观点、原则和价值观的理解。

心脏病学领域一直是数据和循证医学的领导者。考虑到我们领域的医学复杂性，我们不应该成为对医学伦理提及最少的亚专业。该系列是我们期刊的努力，旨在帮助识别和驾驭我们领域的医学灰色地带，并使从业者更容易在现实世界的决策中应用医学伦理。

披露无。

本文表达的观点不一定代表美国心脏协会的观点。

有关披露信息，请参阅第 102 页。