Interdisciplinary Center for Bioethics, Yale University, New Haven, CT 06520-8293, USA.
Semin Perinatol. 2009 Dec;33(6):405-9. doi: 10.1053/j.semperi.2009.07.009.
There is considerable ongoing debate about whether physicians should supply cesarean delivery to patients purely on the basis of maternal demand. This debate is marred by serious definitional problems. Although planned elective cesareans share a risk-profile with "cesarean delivery on maternal demand," not every case of planned elective cesarean results from maternal demand. Ethical and practical considerations counsel using language that is more neutral on the question of the reason for, and process of decision-making leading to, cesarean delivery. Consideration of the risks and benefits of planned elective cesarean, coupled with the desirability of a prophylactic rule limiting physicians' offers of elective cesareans, counsels against making routine offers of elective cesareans to patients. When patients themselves have initiated the conversation about the procedure, physicians may supply elective cesareans only after serious and objective discussion about its risks and benefits.
目前，关于医生是否应该纯粹基于产妇需求提供剖宫产，存在着大量的争议。这场争论存在严重的定义问题。虽然计划的选择性剖宫产与“产妇需求的剖宫产”具有相同的风险特征，但并非每一例计划的选择性剖宫产都源于产妇的需求。伦理和实际考虑因素建议使用更中立的语言来描述导致剖宫产的原因和决策过程。考虑计划选择性剖宫产的风险和益处，加上限制医生提供选择性剖宫产的预防性规则的可取性，反对向患者常规提供选择性剖宫产。当患者自己发起关于该程序的讨论时，医生只有在对其风险和益处进行认真和客观的讨论后，才能提供选择性剖宫产。
