[Surgery of congenital malformations: ethics and economics].

The author summaries the severity of various congenital malformations based on his experience of 30 years of pediatric surgery. Emphasis is placed on the progress that has been made in the treatment of certain anomalies which, up until recently, were considered beyond surgical management. Most advances of diagnosis in utero and changing social attitudes of such malformations have dramatically modified their acceptance. More recently, however, economic factors must be considered because of rising costs. Public service physicians must become aware of these problems. However the decision of whether or not to treat a malformation based solely on its cost-effectiveness should not rest only on their shoulders. This responsibility is to be shown by Society as a whole. The physician, however, should constantly strive to improve the quality of life that will result from the means put at his disposal.