**4. Ethical relativism**

*Neuroethics in Principle and Praxis - Conceptual Foundations*

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**Figure 4.**

**Figure 3.** *The Patient's rights.*

*The tasks and duties of a medical team.*

Healthcare is considered as a universal human right. Culture, faith, socioeconomic factors, and the perception of the value of the education, work, and status of doctors in differing societies are some of the causes of the variance of healthcare in those societies. That variance cannot be deemed as right or wrong, which led to the study and introduction of ethical relativism. Ethical relativism is the view that there are no ethical standards that are absolutely true and must be applied to the societies, without variance. According to the Relativism Theory, a certain event, attitude, or practice may be considered right, if it is accepted as morally correct by the people of the involved society. The same event or attitude may be considered wrong by a society that does not accept it as morally correct.

Throughout the world, most neurosurgical training programs are designed to produce safe, effective neurosurgeons trained to find evidence for the treatment of different neurosurgical problems [4].

Neurosurgeons are obliged to establish ethical and professional relationships with their patients and to that end, should listen to and be guided by both the patient's medical complaint and their perception of the possible outcomes. It is the duty of neurosurgeons to explain to their patients all the steps of investigation, treatment, operation, and possible outcome.

The neurosurgeon can gain valuable knowledge of the patient's culture and beliefs while discussing the benefits and risks of a particular method of management during the course of obtaining informed consent. This knowledge and exchange of information assist in gaining the patient's respect and trust and compliance for both the agreed-upon treatment and its follow-up. Ethical informed consent requires that autonomy and beneficence are applied in equal measure. In applying beneficence, at the expense of autonomy, neurosurgeons may cause irreparable psychological damage [5–7] . Pressure or influence for a particular course of treatment can never be considered ethical, because, although it may be applying the principle of beneficence, it is at the expense of autonomy.

## **5. Evidence-based medicine (EBM) and values-based medicine (VsBM)/ EBM and VsBM**

#### **5.1 What is medical evidence?**

An "evidence" is considered as evidence according to data of a particular cohort study under particular condition of some patient group somewhere. Several scholars and ethicists have raised concern about using the stereotype of evidence to promote a chosen type of therapy or surgery [8]. This attitude may cause bias in selecting evidence to justify certain methods of treatment.

Ross defined the clinical evidence as "In essence, evidence—narrowly defined or not—is a provisional departure point in the consideration of whether or not a particular course of action is to be taken in any clinical context." [9] This definition directly links the evidence to its application but not to the strength, validity, and reliability of the source of that evidence.
