健康・医療情報学ジャーナル

The Professional Responsibility Model of Ethics in Perinatal Medicine

Abstract

Frank A Chervenak*,Laurence B McCullough

Objective: To describe the professional responsibility model of ethics in perinatal medicine, based on the fetus and pregnant woman as patients, to guide the deliberative practice of perinatal medicine. Methods: We describe secular medical ethics and its two fundamental principles, beneficence and respect for autonomy. We articulate the ethical concept of the fetus as a patient on the basis of the ethical principle of beneficence. Results: In the deliberative practice of perinatal medicine guided by the professional responsibility model, the perinatologist should always identify and balance beneficence-based obligations to the fetal patient and beneficence-based and autonomy-based obligations to the pregnant patient. Directive counseling is appropriate when the fetus is a patient. Non-directive counseling is appropriate when the fetus is not a patient. Conclusion: Counseling pregnant women about the clinical management of their pregnancies should always identify and balance beneficence-based obligations to the fetal patient and beneficence-based and autonomy-based obligations to the pregnant patient.