The Orthopaedic Forum article by Black et al. explores a topic that many of us as orthopaedic surgeons frequently encounter but likely have not deeply considered. Certainly, all aspects of our interactions with patients, whether in clinic, on the sideline, or in the emergency room, are complex interactions with a multitude of variables and subsequent consequences that affect the patient, ourselves, and, more largely, the health-care system as a whole. The discipline of modern medical ethics has developed over the last 60 years, largely as a means to help us delve more deeply into those interactions and their consequences. The goal of inquiry is to help us understand how to be better physicians, not only to the individual patients we treat, but also by ensuring that we are appropriately considering the delivery of medical care on a larger societal level.It is likely that most of us, either during or following our training, have had a dilemma in providing patient care that has given us pause, or even required us to seek the help of a medical ethicist. In orthopaedics, this frequently occurs when dealing with issues of patient consent, the use of new devices and implants, and balancing the care of athletes with the needs of teams and organizations, in addition to a host of other issues. However, what we likely do not frequently consider is the ubiquitous practice of removing hardware and what subsequently happens to that hardware once it has been taken out of the patient.Hardware removal has been proven to improve patient outcomes, especially in the trauma setting 1,2 . While this frequently is an elective procedure, it also may be necessary when hardware fails or breaks or there is an infection. Revision procedures also frequently require the removal of orthopaedic implants, sometimes with subsequent reimplantation of new hardware. What do we do with the hardware that we remove? Do we give it to the patient if he or she requests it? Do we provide it to a materials scientist who can study it and potentially determine why it failed? Should it be processed and reused in countries that do not have access to new implants or cannot afford to keep all sizes available? All of these are viable questions that may have different answers depending on the specific scenario.In their article, Black et al. appropriately lay the framework to think about this problem. Specifically, they address the legal, ethical, and scientific considerations related to hardware removal. While there currently is no clear legal precedent, they consider the legality of the ownership of implants, issues related to potential contamination with infectious organisms, and liability, as well as medical device tracking and the resale of explanted devices. The authors discuss the 4 principles of biomedical ethics (autonomy, nonmaleficence, beneficence, and justice) to perform a cursory exploration of the ethical issues surrounding hardware removal. While this is not a complete or robust ethical analysis, it is an excellent introduction and sets the framework...