Elkins T E, Andersen H F, Barclay M, Mason T, Bowdler N, Anderson G
Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor 48109-0718.
Am J Obstet Gynecol. 1989 Jul;161(1):150-4. doi: 10.1016/0002-9378(89)90253-6.
Two previously unreported cases are presented in which court-ordered cesarean sections were considered appropriate by physicians. An analysis of the factors that compel physicians to deem court-ordered intervention appropriate is presented. When the significance of a third-trimester fetal death or a lifetime physical or mental disability is balanced against the demand to uphold maternal autonomy at all costs, the recognized ethical principles of beneficence, nonmaleficence, justice, obstetric contract keeping, and acting in the patients' best interests combine, in rare situations, to override concerns for individual maternal autonomy and justify court-ordered intervention.
本文介绍了两例此前未报告的病例,医生认为法院下令进行剖宫产是合适的。文中分析了迫使医生认为法院下令的干预措施合适的因素。当孕晚期胎儿死亡或终身身体或精神残疾的严重性与不惜一切代价维护产妇自主权的要求相权衡时,公认的行善、不伤害、公正、遵守产科契约以及为患者的最佳利益行事等伦理原则,在极少数情况下,会结合起来压倒对产妇个人自主权的担忧,并证明法院下令的干预措施是合理的。