Chervenak Frank A, McCullough Laurence B
New York Presbyterian Hospital, 525 East 68th Street, M-724, Box 122, New York, NY 10065, USA.
Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, 525 East 68th Street, M-724, Box 122, New York, NY 10065, USA.
Best Pract Res Clin Obstet Gynaecol. 2017 Aug;43:2-9. doi: 10.1016/j.bpobgyn.2016.12.007. Epub 2017 Jan 23.
In this chapter, we present an account of the ethical concept of the fetus as a patient to guide clinical judgment and decision-making in the obstetrician-patient relationship. We explicate this concept and explore its clinical implications on the basis of the professional responsibility model of obstetric ethics. We will emphasize a preventive ethics approach, which is based on the recognition of the potential for ethical conflict in patient care and adopts ethically justified strategies to prevent those conflicts from occurring. The goal of preventive ethics is to sustain a strong obstetrician-patient relationship. This goal is accomplished by balancing beneficence-based and autonomy-based ethical obligations to the pregnant patient with beneficence-based ethical obligations to the fetal patient in all cases in which the fetus is a patient.
在本章中，我们阐述胎儿作为患者的伦理概念，以指导产科医患关系中的临床判断和决策。我们将基于产科伦理的职业责任模型来阐释这一概念，并探讨其临床意义。我们将强调一种预防性伦理方法，该方法基于对患者护理中潜在伦理冲突的认识，并采用符合伦理的合理策略来防止这些冲突的发生。预防性伦理的目标是维持稳固的产科医患关系。在胎儿作为患者的所有情况下，通过平衡对孕妇基于行善和自主的伦理义务与对胎儿患者基于行善的伦理义务来实现这一目标。
