Maternal–Fetal Conflicts  

Oleh:

Cummings, Christy L. ; Mercurio, Mark R.

Jenis: Article from Books - E-Book
Dalam koleksi: Clinical Ethics in Pediatrics A Case-Based Textbook, page 51-56.
Topik: Maternal; Fetal Conflicts; Ethical Principles
Fulltext: Maternal–Fetal Conflicts.pdf (126.53KB)

Isi artikel

Multiple ethical issues and dilemmas can arise in the care of the pregnant woman, as illustrated by this case. The term maternal–fetal conflict has been widely used to describe situations when pregnant women “reject medical recommendations, use illegal drugs or engage in a range of other behaviors that have the potential to cause fetal harm” (ACOG, 2005 ). The ethical issues central to these dii cult situations include, but are not limited to: a woman’s right to autonomy (“self-rule”), the rights of the fetus and/or future child, justice for both mother and fetus, the mother’s moral obligations, and the physician’s moral and professional obligations. For the case described above, several questions arise. Which ethical obligation or duty takes precedence, the duty to respect LC’s autonomous decision, or the duty to benefit her viable fetus? Can the physician ensure fair treatment towards LC and still promote the wellbeing of her fetus? And finally, should pregnant women be punished for behavior, such as refusal of a recommended treatment, that ultimately harms their fetus or future child? Some argue that the term maternal–fetal conflict should be replaced with maternal–fetal relationship , in order to avoid perceiving the pregnancy as an adversarial or mutually exclusive relationship between the pregnant woman and her fetus (Gilligan, 1982 ; Harris, 2000 ; Tong & Williams, 2009 ). Indeed, the interests of the mother and fetus are nearly always concordant. It should also be noted that the conflict could be perceived as not between the mother and fetus, but rather between the mother and physician, and some thus prefer the term maternal–physician conflict (Harris, 2000 ; ACOG, 2005 ). Though each of these suggestions has some validity, it must be acknowledged that there may be some cases in which the mother’s refusal truly is in conflict with the interests of the fetus, or the future child. The case being considered may be one such example. For the purposes of this chapter, we will use the term maternal–fetal conflict, as it is commonly used in the literature, recognizing the limitations and connotations of the term itself.

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