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Guidelines for Elective Pediatric Fiberoptic Intubation
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Why the Elective Caesarean Lottery is Ethically Impermissible.

Elizabeth Chloe Romanis1

  • 1Centre for Social Ethics and Policy, School of Law, University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK. elizabeth.romanis@manchester.ac.uk.

Health Care Analysis : HCA : Journal of Health Philosophy and Policy
|May 1, 2019
PubMed
Summary

Women

Keywords:
AutonomyBirth ethicsCaesarean sectionChildbirthElective caesareansPregnant women

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Area of Science:

  • Medical Ethics
  • Obstetrics
  • Women's Health

Background:

  • UK law and NICE guidelines support women's informed choices in childbirth.
  • Medical guidance explicitly supports maternal request for caesarean section (MRCS) without clinical indications.
  • Despite guidelines, women are frequently denied MRCS in practice.

Purpose of the Study:

  • To examine the justification for restricting maternal request for caesarean section (MRCS).
  • To determine if current practices align with ethical norms of respecting autonomous choices in childbirth.
  • To investigate the disparity between legal/medical guidance and the reality of MRCS access.

Main Methods:

  • Analysis of UK law and NICE guidelines regarding childbirth choices.
  • Ethical argument evaluating justifications for restricting MRCS.
  • Examination of the concept of patient autonomy in the context of pregnancy.

Main Results:

  • Access to MRCS in the UK is inconsistent and varies significantly.
  • Ethical justifications commonly cited against MRCS are insufficient to override the principle of patient autonomy.
  • Pregnancy does not present unique ethical considerations that negate the norm of respecting informed patient choices.

Conclusions:

  • Maternal request for caesarean section (MRCS) should be respected and made available to pregnant women.
  • The current 'lottery' system for accessing MRCS in the UK must be addressed.
  • Ethical frameworks support autonomous decision-making in childbirth, including elective caesarean sections.