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Chapter 26 - Ethical Issues

from Part IV - SPECIAL ISSUES

Published online by Cambridge University Press:  07 May 2010

John Patrick O'Grady
Affiliation:
Tufts University, Massachusetts
Joanna M. Cain
Affiliation:
Professor and Chair, Department of Obstetrics and Gynecology
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Summary

The moral conflicts that surround abortion, prenatal diagnosis, invasive fetal therapy, and maternal refusal of recommended care all carry an implied concern for the dependent variable in the choices made, the fetus. The social context is important in understanding the maternal-fetal relationship; however, genetic linkages that have traditionally been called on in this context are being challenged by surrogacy and other reproductive technologies. Continued fetal existence depends on an intact maternal circulation. Access to the fetus is possible only by accepting varying levels of maternal risk. Physicians can also be, secondarily, advocates for fetal well-being, but not at the expense of their obligation to the mother. If physicians can maintain this ethical focus, it is likely to encourage use of the medical care system by those wary of implied police activities of healthcare givers.

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