The ethics of maternal-fetal surgery

Maternal-fetal surgery is performed on two patients, the pregnant patient and the fetal patient. Ethics is therefore an essential dimension of maternal-fetal surgery. From its beginnings in only a few centers, various procedures have become available in highly specialized centers in developed countries. Innovation and research have played an indispensable role in the development of maternal-fetal surgery and will continue to do so. In this article we present ethically justified criteria, based on the ethical concept of the fetus as a patient, for clinical innovation and research of maternal-fetal surgery and for the professionally responsible transition from innovation and research into clinical practice. These criteria are designed to be used by clinical innovators, clinical investigators, and by oversight committees.