Truth telling and severe fetal diagnosis: a virtue ethics perspective

J Perinat Neonatal Nurs. Jan-Mar 2011;25(1):13-20. doi: 10.1097/JPN.0b013e318201edff.

Abstract

Purpose: Increased use of prenatal technologies has increased the numbers of women and partners whose fetus is diagnosed with a severe impairment. Virtue ethics provides a useful perspective to consider truth telling in this context, specifically how couples and providers interpret the diagnosis and prognosis to create truth. Virtue ethics is person-centered rather than act-centered, with moral actions guided by how a virtuous person would act in the same circumstance. Phronesis (practical wisdom) guides these actions.

Subjects and methods: Fifteen women and 10 male partners with a severe fetal diagnosis participated in this longitudinal ethnography examining their experiences across 3 available care options: termination, routine obstetric care, and perinatal end-of-life care. Data from 39 interviews were analyzed to determine how they created meaning and truth in context of the diagnosis.

Results and conclusions: Providers' interactions were usually, but not always, characterized by the practice of phronesis. Couples were in a more complex moral situation than were providers. Those who terminated created a socially acceptable truth within a negative social environment related to abortion. Those seeking routine care had uncertain fetal prognoses and struggled with the meanings of "odds" of survival. One couple with end-of-life care experienced a close alignment of the facts and the truth they made public.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / nursing*
  • Abnormalities, Multiple / psychology*
  • Adaptation, Psychological
  • Adult
  • Ethics, Nursing
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Neonatal Nursing / ethics*
  • Nurse-Patient Relations / ethics*
  • Parents / psychology*
  • Philosophy, Nursing
  • Pregnancy
  • Truth Disclosure / ethics*
  • Young Adult