Implementation of the Ulysses contract in a patient with severe needle phobia: a case report

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S Ayoub1, N Pate1, J Sheeran1

  • 1Department of Anesthesia, University of Virginia Health System, PO Box 800710, Charlottesville, VA 22908, United States.

International Journal of Obstetric Anesthesia
|January 15, 2026
PubMed

Respecting patient autonomy can present complex challenges in obstetric anesthesia, particularly when a mother desires safe maternal-fetal care but is unable to cooperate due to psychological barriers. The Ulysses contract is a framework that allows patients to consent to treatment in advance if they are to lack decision making capacity later. This case illustrates a unique implementation of the Ulysses contract in an obstetric patient in which involvement of early multidisciplinary support was paramount to allow safe and timely medical care that aligned with the patient's wishes.

Keywords:
Advance directiveEthicsNeedle phobiaUlysees contract

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