Changing the old order: neurosurgery and ethics at the millennium

The profound changes in biotechnology which have challenged established beliefs in western society over the last 30 years have resulted in ethical problems which affect neurosurgeons no less than other medical scientists. This paper examines some of these changes in the context of neurological aspects of bioethics and argues a justification for the active involvement of clinical neurosurgeons in the vigorous debates in society today. In order to adapt to these changes, neurosurgeons will need to learn about ethical systems as utilities to resolve the conflicts thrown up by biotechnology and pay particular attention to such diverse issues as the quality of training programs, continuing medical education, the establishmnt of standards of care and membership of Institutional Ethics Committees.