Preview

Obstetrics, Gynecology and Reproduction

Advanced search

ETHICS IN OBSTETRIC PRACTICE

Full Text:

Abstract

Ethics is an essential dimension of obstetric practice. There is defined medical ethics and the fundamental ethical principles of beneficence and respect for autonomy. We then show how these two principles should interact in obstetric judgment and practice with emphasis on the core concept of the foetus as a patient. We then describe the professional responsibility of obstetric ethics. Obstetricians have beneficence based and autonomy-based obligations to the pregnant patient and beneficence-based obligations to the foetal patient.The result is evidence- based clinical judgement about diagnostic and therapeutic measures that are reliably expected to result in a greater balance of clinical goods over clinical harms. The pregnant woman's autonomy is empowered by offering or recommending medically reasonable alternatives. The informed consent process should be used as a preventive ethics tool.

About the Authors

F. A. Chervenak
Department of Obstetrics and Gynecology, Weill Medical College of Cornell University (New York, USA)
United States


L. B. McCullough
Center for Medical Ethics and Heath Policy, Вауlor College of Medicine (Houston, USA)
United States


References

1. Annas G.J. Protecting the liberty of pregnant patient. N Engl J Med. 1988; 316: 1213-4.

2. Beauchamp T.L., Childress J.F. Principles of Biomedical Ethics (6th ed.). New York, NY: Oxford University Press. 2009.

3. Buckley S. Reclaiming every woman's birthright. Midwifery Today. Int Midwife. 2010; 94: 40-1.

4. Callahan S., Callahan D. (eds.) Abortion: Understanding Differences. New York, NY: Plenum Press. 1984.

5. Chervenak F.A., McCullough L.B., Brent R.L. The professional responsibility model of obstetric ethics: avoiding the perils of clashing rights. Am J Obstet Gynecol. 2011; 205: 315.e1-5.

6. Chervenak F.A., McCullough L.B. The limits of viability. J Perinat Med. 1997; 25: 418-20.

7. Chervenak F.A., McCullough L.B., Levene Ml. An ethically justified clinically comprehensive approach to periviability: gynaecological, obstetric, perinatal, and neonatal dimensions. J Obstet Gynaecol. 2007; 27: 3-7.

8. Chervenak F.A., McCullough L.B. The moral foundation of medical leadership: the professional virtues of the physician as fiduciary of the patient. Am J Obstet Gynecol. 2001; 184: 875-9.

9. Engelhardt H.T., Jr. The Foundations of Bioethics (2nd ed.). New York, NY: Oxford University Press. 1995.

10. Faden R.R., Beauchamp T.L. A History and Theory of Informed Consent. New York, NY: Oxford University Press. 1986.

11. Hogberg U., Lynoe N., Wulff M. Caesarean by choice? Empirical study of public attitudes. Acta Obstet Gynecol Scand. 2008; 87: 1301-8.

12. Johnson LSM. Abortion: II. Contemporary ethical and legal aspects: A. Ethical perspectives. In: Encyclopedia of Bioethics. Post S.G. (ed). New York, NY: Macmillan References; 2004: 7-18.

13. Lyerly A.D., Little M.O. Toward an ethically responsible approach to vaginal birth after caesarean. Semin Perinatol. 2010; 34: 337-44.

14. Minkoff H., Paltrow L. Obstetricians and the rights of pregnant women. Womens Health (Lond Engl). 2007; 3: 315-9.

15. Minkoff H. NIH Vaginal Birth after Caesarean: New Insights. National Institutes of Health Consensus Development Conference, March 10-13 2010; 6. Day 2 Discussion, available at http://videocast.nih.gov/summary.asp?Live=8408, accessed November 18, 2012.

16. McCullough L.B., Chervenak F.A. Ethics in Obstetrics and Gynecology. New York, NY: Oxford University Press. 1994.

17. McCullough L.B. The ethical concept of medicine as a profession: its origins in modern medical ethics and implications for physicians. In: Lost Virtue: Professional Character Development in Medical Education. Kenny N., Shelton W., (eds). New York: Elsevier. 2006; 17-27.

18. Schloendorff V. The Society of the New York Hospital, 211 N.Y. 125, 126, 105 N.E. 92, 93 (1914).

19. Temkin O., Temkin C.L. (eds.) Hippocrates. Oath of hippocrates. Ancient Medicine: Selected Papers of Ludwig Edelstein. Baltimore, MD: Johns Hopkins University Press. 1976; 6.


For citation:


Chervenak F.A., McCullough L.B. ETHICS IN OBSTETRIC PRACTICE. Obstetrics, Gynecology and Reproduction. 2014;8(3):47-52. (In Russ.)

Views: 188


ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)