Jankowski Jane, Burcher Paul
Albany Medical College, 47 New Scotland Avenue, Mail Code 153, Albany, New York 12208 USA.
Obstetrics and Gynecology, Albany Medical College, Albany, New York 12208 USA.
J Clin Ethics. 2015 Spring;26(1):27-35.
This article presents the case of a mother who is planning a home birth with a midwife with the shared knowledge that the fetus would have congenital anomalies of unknown severity. We discuss the right of women to choose home birth, the caregivers' duty to the infant, and the careproviders' dilemma about how to respond to this request. The ethical duties of concerned careproviders are explored and reframed as professional obligations to the mother, infant, and their profession at large. Recommendations are offered based on this case in order to clarify the considerations surrounding not only home birth of a fetus with anticipated anomalies, but also to address the ethical obligations of caregivers who must navigate the unique tension between respecting the mother's wishes and the duty of the careproviders to deliver optimal care.
本文介绍了一位母亲的案例,她计划在家中由助产士接生,大家都知道胎儿会有严重程度未知的先天性异常。我们讨论了女性选择在家分娩的权利、护理人员对婴儿的责任,以及护理提供者在如何回应这一请求时所面临的困境。探讨了相关护理人员的道德义务,并将其重新界定为对母亲、婴儿以及整个行业的职业义务。基于此案例提出了建议,以阐明围绕不仅是有预期异常胎儿的家庭分娩的相关考量,同时也为必须在尊重母亲意愿与护理人员提供最佳护理职责之间应对独特紧张关系的护理人员的道德义务提供指导。