[Hippocrates or Taigetos--ethical dilemmas in neonatal surgery]

As a result of the decrease of the medical authority and the increasing power of the lawyers, the relationship between doctors and patients, patients and society has changed. The situation is more complicated in the case of neonates, infants and children who are unable to articulate their rights and wishes. The problem is complex in connection with the fetus because their interest and that of the mothers are often in conflict. The neonatal surgeon--only together with the geneticist, obstetrician and neonatologist--plays and important role in the evaluation of the mentally or somatically handicapped fetuses and neonates. The neonatal surgeon should suggest the termination of a pregnancy, should give his/her expert opinion about the result of the treatment of a malformation or should propose the withdrawal of the intensive care in the case of a critically ill neonate. Fetuses and neonates with congenital anomalies can be divided into 6 groups. 1. potential for total recovery--2. anomaly enabling a nearly normal life--3. malformations requiring permanent supervision and/or medical care--4. somatic rest defect and subnormal mental development--5. serious somatic and mental damage--6. anomal incompatible with life. In the complex evaluation of a fetus or a neonate with congenital malformation the neonatal surgeon--while not forgetting his/her Hippocratic oath--should take into consideration the quantity and quality of the rescued life, possibilities of a long treatment he/she should act according to the law and fulfil the expectations of the society.