Ethical dilemma of late pregnancy termination in cases of gross fetal malformations

Modern diagnostic methods reveal an increased number of cases of gross fetal malformations, and physicians are faced with serious ethical considerations. The disclosure of data during conversations with the parents, the decision-making process and the different courses of action are discussed. Cases with defined diagnoses may be divided into three different clinical situations: 1) a malformation incompatible with extrauterine life; 2) increasing organ damage caused by a fetal defect; and 3) a severely handicapped fetus capable of short- or long-term survival. The recent concept of fetal abuse is emphasized. When pregnancy is allowed to continue to term in these cases, psychological and social aspects must be taken into consideration. Medical assessment, ethicolegal norms, and religious beliefs of parents and physicians should guide the course of action. We believe that the medical team should perform late termination of pregnancy when justified and approved by a court or a statutory committee.