Fetal Surgery: Whose Decision

Mater-fetal conflict – a significant and influential concept in ethical decision making in the field of gynaecology – arises in fetal surgeries more than any other medical procedure. This is because fetal surgery ought to be run by invading the mother’s body. Risks and consequences which open fetal surgery brings about for the mother give rise to certain prominent questions. In which circumstances is such a surgery reasonable Should the surgery be limited to cases where the life of the fetus is in danger Or, is it justified given the advantages of in utero surgery (e.g. quicker healing with less scar tissue) over postnatal surgery with its risks and consequences Finally, who has the right to decide on this issue Bio-ethicists, by taking into account the direct involvement of the mother and her deep emotional bond with the fetus, give two completely opposite answers to the above question. One group believe that since most of mothers give priority to the fetus interests, hence, their decisions are not based on two important elements of self-protection and risk avoidance. Therefore, an autonomy based bioethics may not accept the mother’s decision. In contrast, another group maintains that as the mother would be affected by this decision, more than anybody else, more space has to be given to her in such a decision making.The first answer can be a slippery slope to paternalism for bioethics and it seems that brings about more problems, rather than solving any, though rightly emphasizes on the necessity of protecting the mother. Accordingly, the second response appears more plausible. An autonomous decision by the mother may be guaranteed by reducing the pressure of relatives and family members on the mother, correcting the quasi-norms that create expectation of sacrifice on the mother, and of course fully informing her of the risks and consequences of the surgery.

کلیدواژه ها:

fetal surgery ، maternal-fetal conflict ، autonomy ، bioethics