**2. Definition and the concept of values-based medicine**

Values-based medicine (VsBM) is the concept to ensure that the principles of medical ethics are strictly implemented and observed in every step of a patient's management.

*Values-based medicine can be defined as "medical practice that aims at maximizing value, specifically desirable or positive value in every step of a patient's medical management".*

The concept of values-based medicine (VsBM) stresses on the fact that patient, patient care, and well-being are the center of care in modern medicine. The treating neurosurgeons, physicians, or healthcare givers should spare no effort to improve their skills, update their knowledge, and learn to use the latest technology in order to provide the best care for the patient. The treating team should have a vision and build up a strategy of management and follow-up of their patients. All these necessary steps should be performed within a frame of values and medical ethics. The treating teams should respect and observe the patient and value and respect the culture of the society. Evidence-based medicine should be considered an important component of values-based medicine [1].The key elements of values-based medicine which, like evidence-based medicine, influence any clinical decisions may be taken for patients' management (**Figure 1**).

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**Figure 2.**

*The principles of medical ethics.*

*Values-Based Medicine (VsBM) and Evidence-Based Medicine (EBM)*

Based on the Hippocratic Oath, the main ethical principles were beneficence (do the best for patients) and non-maleficence (do no harm). These two principles were considered to be the fundamental principles of medical ethics for hundreds of years. The principles of medical ethics/bioethics were expanded to include autonomy (patient's right to accept or refuse the method of treatment) and justice. Justice in medicine considers the distribution of healthcare facilities and the access of all patients to these facilities. One of the positive characters of the last and this century is the respect and observation of human rights. Therefore the human rights were manifested clearly in the medical ethics, as the medical ethics expanded again to (a) autonomy, (b) beneficence, (c) non-maleficence, (d) justice, (e) dignity, and

The respect of patients' rights is one of the main foundations of the concept of values-based medicine. Patients should be considered as partners and share in the process of management. Patients should agree and consent to every step of treatment. Patients have the right to be fairly and properly treated; follow-up should be guaranteed. A patient's privacy, dignity, and confidentiality should be respected. Dignity encompasses a feeling of self-worth and equality. It is paramount that the patient be treated as a person with a disease, rather than a disease that a person has. The patient should also feel he is an equal partner in decision-making, and not just a bystander or subordinate. Patients should be educated and learn about their medical problems, treatment options, and the prognosis. Patients must know who the treating team is, their experiences and qualifications. Patients should have the right to complain in the cases of dissatisfaction about the treatment or lack of communication. Most of these rights are illustrated in **Figure 3**. These fundamental human rights are listed in the WHO recommendation [2] and the World Federation

The concept of values-based medicine draws the outlines of the duties and tasks of the treating team as illustrated in **Figure 4**. These duties include respecting the

(f) truthfulness and honesty. **Figure 2** demonstrates these principles.

of Neurological Societies as good practice guideline [3].

**3.2 The duties and task of the treating teams**

*DOI: http://dx.doi.org/10.5772/intechopen.88393*

**3. The principles of medical ethics**

**3.1 Patients' rights**

**Figure 1.** *The concept of values-based medicine (VsBM): patient is the center of care.*
