Ethical issues in fetal therapy

Best Pract Res Clin Obstet Gynaecol. 2017 Aug;43:58-67. doi: 10.1016/j.bpobgyn.2017.02.005. Epub 2017 Feb 12.

Abstract

The introduction of routine fetal ultrasound and the technical improvements in ultrasound equipment have greatly increased our ability to diagnose fetal anomalies. As a consequence, congenital anomalies are diagnosed today earlier and in a greater number of patients than ever before. The development of fetal intervention and fetal surgery techniques, improved anesthesia methodology, and sophisticated perinatal care at the limits of viability, have now made prenatal management of some birth defects or fetal malformations a reality. The increasing number of indications for fetal therapy and the apparent desire of parents to seek out these procedures have raised concern regarding the ethical issues related to the therapy. While fetal therapy may have a huge impact on the prenatal management of some congenital birth defects and/or fetal malformations, because of the invasive nature of these procedures, the lack of sufficient data regarding long-term outcomes, and the medical/ethical uncertainties associated with some of these interventions there is cause for concern. This chapter aims to highlight some of the most important ethical considerations pertaining to fetal therapy, and to provide a conceptual ethical framework for a decision-making process to help in the choice of management options.

Keywords: fetal malformation; fetal surgery; fetal therapy; fetus; medical ethics; pregnancy.

Publication types

  • Review

MeSH terms

  • Congenital Abnormalities / therapy*
  • Counseling
  • Decision Making*
  • Female
  • Fetal Therapies / ethics*
  • Humans
  • Pregnancy
  • Prenatal Diagnosis
  • Ultrasonography, Prenatal*