Ethical issues in fetal surgery. 2003

Edmund G Howe
Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799, USA. ehowe@usuhs.mil

Fetal surgery involves unique ethical issues because the interests of fetus and mother may conflict but, regardless, they are inextricably interconnected. Controversial questions currently include what kinds of surgery should be permitted, who should decide, and whether this surgery should be restricted to specialized centers. Clinical questions include the degree to which mothers should have decision-making authority, the extent, if any, to which mothers should be protected from pressure from family members, and whether physicians should be non-directive. This article discusses these questions and their answers' competing rationales. It also presents recent data from attachment studies of mothers and infants and from neuroscience, which suggest that mothers and infants are more interdependent physiologically and psychologically than has been understood. The paper describes how these findings may apply to the mother and fetus long before it is born. The major implication of this analysis is that mothers should, perhaps, have greater decision making authority.

UI MeSH Term Description Entries
D009035 Mothers Female parents, human or animal. Mothers' Clubs,Club, Mothers',Clubs, Mothers',Mother,Mother Clubs,Mother's Clubs,Mothers Clubs,Mothers' Club
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D005220 Fathers Male parents, human or animal. Father
D005260 Female Females
D005333 Fetus The unborn young of a viviparous mammal, in the postembryonic period, after the major structures have been outlined. In humans, the unborn young from the end of the eighth week after CONCEPTION until BIRTH, as distinguished from the earlier EMBRYO, MAMMALIAN. Fetal Structures,Fetal Tissue,Fetuses,Mummified Fetus,Retained Fetus,Fetal Structure,Fetal Tissues,Fetus, Mummified,Fetus, Retained,Structure, Fetal,Structures, Fetal,Tissue, Fetal,Tissues, Fetal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D026690 Ethics, Clinical The identification, analysis, and resolution of moral problems that arise in the care of patients. (Bioethics Thesaurus) Clinical Ethics
D028701 Patient Rights Fundamental claims of patients, as expressed in statutes, declarations, or generally accepted moral principles. (Bioethics Thesaurus) The term is used for discussions of patient rights as a group of many rights, as in a hospital's posting of a list of patient rights. Right to Treatment,Patient's Rights,Patients' Rights,Patient Right,Patient's Right,Patients Rights,Patients' Right,Right to Treatments,Right, Patient,Right, Patient's,Right, Patients',Rights, Patient,Rights, Patient's,Rights, Patients',Treatment, Right to,Treatments, Right to

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