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Fatal fetal paternalism.

Dominic Wilkinson1

  • 1Discipline of Obstetrics and Gynecology, Women's and Children's Hospital, University of Adelaide, 72 King William Rd, North Adelaide, SA 5006, Australia. dominic.wilkinson@adelaide.edu.au

Journal of Medical Ethics
|March 1, 2012
PubMed
Summary
This summary is machine-generated.

Obstetrician counseling for severe fetal anomalies is often directive, not neutral, and varies significantly among clinicians in the US. This commentary discusses concerns and suggests the survey may promote more consistent management approaches.

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Area of Science:

  • Medical ethics
  • Obstetrics and Gynecology
  • Clinical practice variation

Background:

  • Severe fetal anomalies present complex management challenges for obstetricians.
  • Current clinical practices and counseling approaches require examination.

Purpose of the Study:

  • To analyze the findings of Heuser and colleagues' survey on obstetrician management of severe fetal anomalies.
  • To discuss the implications of non-neutral counseling and practice variability.

Main Methods:

  • Commentary on a survey of obstetricians regarding management of severe fetal anomalies.
  • Analysis of counseling directiveness and inter-clinician variability.

Main Results:

  • Survey reveals counseling for severe fetal anomalies is frequently non-neutral.
  • Significant variability exists in clinical management approaches among obstetricians.

Conclusions:

  • Directive counseling may represent medical paternalism.
  • Variability in practice likely stems from physician personal values.
  • The survey offers a path toward more consistent management of fetal anomalies.