Counseling patients when abortion is legal and the fetus is viable

In the wake of the 1973 US Supreme Court decision legalizing abortion, many states instituted laws allowing voluntary termination of pregnancy up to 24 weeks. Improvements in neonatal medicine since then mean that some fetuses may be viable at gestational ages less than 24 weeks. Thus clinicians and patients may confront the dilemma of the fetus that is both legally "abortable" and potentially viable. If the obstetrical team automatically (without considering all reproductive options) attempts to salvage the fetus, they abrogate the woman's right not to deliver an extremely premature infant. In this clinical opinion, we review the ethical issues that should be considered in the management of these situations.