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Court-ordered obstetrical interventions.

V E Kolder, J Gallagher, M T Parsons

    The New England Journal of Medicine
    |May 7, 1987
    PubMed
    Summary
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    Court-ordered obstetrical procedures are increasingly used when women refuse treatment for fetal health. This practice raises significant legal and ethical concerns among obstetricians, impacting maternal and infant care.

    Area of Science:

    • Medical Law
    • Obstetrics and Gynecology
    • Bioethics

    Background:

    • Court orders for obstetrical procedures are being sought when pregnant individuals refuse medical interventions deemed necessary for fetal well-being.
    • This practice raises significant ethical and legal questions within maternal-fetal medicine.

    Purpose of the Study:

    • To investigate the prevalence and circumstances of court-ordered obstetrical procedures.
    • To gather expert opinions from maternal-fetal medicine specialists on these cases.

    Main Methods:

    • National survey of court-ordered obstetrical procedures.
    • Solicitation of opinions from maternal-fetal medicine fellowship program directors.

    Main Results:

    • Court orders were obtained in 86% of 21 cases for procedures like cesarean sections and intrauterine transfusions.

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  • The majority of women involved were minorities, unmarried, or non-native English speakers, often receiving care at teaching hospitals or public assistance.
  • A significant portion of maternal-fetal medicine specialists supported detention or court orders in such situations.

    • Conclusions:

    • Court-ordered obstetrical procedures are a growing concern with divided expert opinions.
    • These interventions are based on questionable legal grounds and may negatively affect obstetrical practice and patient health.
    • The practice has profound implications for maternal and infant health outcomes and patient rights.