Neurosurgical Ethics in Practice: Value-based Medicine

An Elderly Man Suffers a Renal Cell Carcinoma Metastasis in the Pineal Gland: Lessons Learned and Ethical Considerations

“…The ethical code of the American Medical Association included nine principles of medical ethics as the main component of the Ethical Code. These principles are: 1) Ethics of patient-physician relationship, 2) Ethics of consent, communication & decision making, 3) Ethics of privacy, confidentiality, and medical records, 4) Ethics of genetics and reproductive medicine, 5) Ethics of caring for patients at the end of life, 6) Ethics of organ procurement and transportation, 7) Ethics of medical research and innovation, 8) Ethics of physicians and health care community, and 9) Ethics of interprofessional relationship [21]. The concept of Values-Based Medicine (VsBM) which was introduced recently focused on the theory that "the patient is the center of care" and describes the ethical principles needed in order to implement the ethical principles in every step of the daily practice.…”

“…The concept of Values-Based Medicine (VsBM) which was introduced recently focused on the theory that "the patient is the center of care" and describes the ethical principles needed in order to implement the ethical principles in every step of the daily practice. These ethical principles are: autonomy, beneficence, non-maleficence, justice, dignity, truthfulness, and honesty [21].…”

“…The patient has the right to be informed about the seriousness of the disease and the consequences of refusal of treatment or neglecting the follow-up plan [21]. For example, patients who were operated on and their histopathology results were inconclusive, should be informed that the risk of tumor is still there, and they must go for a second surgery for a biopsy and possible adjuvant therapy.…”

“…For instance, the coordinators of the outpatient clinics should receive a list of patients who may have serious conditions and should ensure that these patients have the priority to be seen earlier. If the received treatment was not properly executed, or there have been medical mistakes or errors, the patient and the family should have the right to complain to the hospital authorities (e.g., the public relations department or to an administrator) [21]. Medical errors are more common in surgical specialties.…”

“…Disclosure will promote public trust as well as justice and will also prevent further harm. Moreover, disclosure respects the patient and his/her autonomy [21].…”