WFITN ethics charter.

Since the foundation of the World Federation of Interventional and Therapeutic Neuroradiology (WFITN) 25 years ago, one of the goals that some previous Executive Committees had on their program was to create an official Charter of Ethics. Nevertheless, multiple attempts to create an Ethics Committee to write a charter have regularly failed. Why? The origin of this failure could be found in the fact that even if we have friendly close relationships inside our federation, our origins are very various and different, coming from all over the world and from different specialties. Consequently, we do not share the same cultures, the same religions, the same ways of life, the same beliefs . . .which leads to the fact that value of the human life is not appreciated in the same way within our different countries and continents. According to that situation, the solutions we can choose to take a difficult decision are obviously not always identical, which is absolutely normal. It explains why nowadays, many societies have written their own Charter of Ethics, all of which are often very different. In 2014, thanks to the dynamism and the energy of Georges Rodesch, President of theWFITN, it was at last decided to dedicate the next annual WFITN seminar to ethics. The seminar was held during the 2015 ABCWIN meeting in Val d’Isère. Professor Felix Umansky, former Chairman of the Ethics and Medico-Legal Affairs Committee of the World Federation of Neurosurgery (2005–2013), was invited to present to us the World Federation of Neurosurgery (WFNS) Ethics Charter and the way his group achieved consensus inside the WFNS. During the same working session, some colleagues coming from different parts of the world have described the main ethical concerns of their countries. This allowed us to write this draft. We have not only used our own experience based on multiple discussions between us inside our World Federation, but we have also drawn some inspiration from the WFNS charter, which is one of the best ethics charters already published globally. In the months following the 2015 seminar, we have worked to write a proposed charter, taking into account the different points of view that have been collected. This draft has been carefully analyzed, and then modified during the last 2016 WFITN seminar in Val d’Isère under the current presidency of Sirintara Pongpech, thus resulting in this official document. The WFITN ethics charter is based on evidence, assessments, and questions. It is a document that is intended to be remodeled and to evolve. Nobody indeed owns the truth, and sometimes what we believe to be the truth today can be completely wrong tomorrow. We must thus be aware that our personal ethics will remain subject to change, and will have to be adapted according to the evolution of the countries and societies in which we live. Ethics is in the field of doubt. It explains why our charter cannot be a list of rules applicable to all patients in all countries. Its goal is to indicate some principles, allowing us to think together inside our own teams about how to choose the best, or very often the least bad solution for our patients. We must remain modest and indulgent. For some very sensitive topics, it was not possible to reach a consensus. Consequently, as for the training recommendations, this charter will certainly be discussed again and modified in the future.