Abstract
End-of-life care in neuro-oncology presents complex challenges that extend beyond surgical interventions, particularly in resource-limited settings such as Kenya and Uganda. Neurosurgeons often face difficult ethical dilemmas, including deciding when surgery is futile, managing family expectations for aggressive treatment, and addressing the realities of palliative care gaps. These challenges are compounded by cultural and religious beliefs, financial constraints, and limited access to adjuvant therapies. This presentation explores the neurosurgery resident’s perspective on navigating these dilemmas, highlighting key issues such as balancing hope with medical realism, ethical triage in public hospitals, and the emotional toll of caring for terminal neuro-oncology patients. Through case-based discussions and regional insights, we examine how to foster compassionate communication, advocate for early palliative care integration, and create ethical frameworks that respect both patient autonomy and clinical judgment. By addressing these sensitive yet critical aspects of neuro-oncology, this talk aims to encourage open conversations within the neurosurgical community, promote patient-centered care, and advance ethical decision-making in the face of life-limiting illness.