In an editorial published today in the European Journal of Cardio-Thoracic Surgery, Leslie Hamilton – former president of the Society for Cardio-Thoracic Surgery in Great Britain and Ireland and regional director for professional affairs at the Royal College of Surgeons of England – discusses the question of when an emerging technology should enter the therapeutic arena. Commenting specifically on the Personalised External Aortic Root Support (PEARS) he argues that, following a precedent set in a recent Supreme Court case, surgeons have a responsibility to provide information on all appropriate medical procedures to allow the patient to make an informed decision. He suggests that patients should be made aware of the PEARS option.