Ethico-legal regional differences in European neurosurgical practice: Part 1-pre-COVID-19 era

Tiit I Mathiesen, Naci Balak*, Nicolás Samprón, Marike Broekman, Ciarán Bolger, EANS Ethico-legal committee

*Corresponding author for this work


Introduction: Professionalism entails expert knowledge, self-regulation, accountability, and professional ethics. These factors are influenced by culture, political observance, professional maturity, education, and occupation; ethical practices may thus vary between countries and affect how neurosurgery is practiced.

Research question: This paper aims to conduct a survey that addresses whether ethico-legal practices differ in European countries and whether existing ethical guidelines have been implemented.

Material and methods: A questionnaire survey was used to examine the ethico-legal situation in 29 European countries or regions. The reports were validated by representatives of each nation.

Results: Existing guidelines had been implemented to a minimal extent. Major regional and national differences were found in attitudes toward life and death, prioritization, and issues related to professional conduct.

Discussion and conclusion: The results of this survey reveal inadequacies and weaknesses of policies and resources, which should spark national discussions to improve the conditions that influence professional ethics. Unfortunately, only a minority of neurosurgeons know the neurosurgical ethics guidelines and apply them in their decision making. Our findings highlight the importance of values and professional ethics in decision making.

Original languageEnglish
Article number100899
JournalBrain & spine
Pages (from-to)100899
Publication statusPublished - 2022


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