Staff Lynne, Nash Meredith
University of Tasmania, Australia.
University of Tasmania, Australia.
Women Birth. 2017 Oct;30(5):354-360. doi: 10.1016/j.wombi.2017.01.009. Epub 2017 Mar 18.
To discuss corporeal support of the brain-dead pregnant woman and to critically examine important aspects of this complex situation that remain as yet unexplored.
When brain death of the woman occurs during pregnancy, the fetus may be kept inside the corporeally supported body for prolonged periods to enable continued fetal growth and development. This has been increasingly reported in medical literature since 1982 and has received considerable media attention in the past few years.
Sophisticated advances in medical technologies have altered the boundaries of conception and birth, life and death, Western biomedical and cultural conceptions of women and their bodies, fetal personhood, fetal rights and fetal patienthood, profoundly influencing maternal behaviors, medical decisions and the treatment of pregnant women. This is especially so in the rare, but fraught instance of brain death of the pregnant woman, where nurses and midwives working in High Dependency Care units undertake the daily care of the corporeally supported body that holds a living fetus within it. This discussion enables critical and ethical conversation around the complexities of developing appropriate discourse concerning the woman who suffers brain death during pregnancy and considers the complexities for nurses and midwives caring for the Woman/body/fetus in this context. The potential impact on the fetus of growing and developing inside a 'dead' body is examined, and the absence in the literature of long-term follow up of infants gestated thus is questioned.
探讨脑死亡孕妇的身体支持,并审慎审视这一复杂情况中尚未得到探索的重要方面。
当孕妇在孕期发生脑死亡时,胎儿可在身体得到支持的情况下长时间留在母体内,以实现其持续生长发育。自1982年以来,医学文献中对此的报道日益增多,在过去几年中也受到了媒体的广泛关注。
医学技术的复杂进步改变了受孕与分娩、生与死、西方生物医学及文化对女性及其身体的观念、胎儿人格、胎儿权利和胎儿患者身份的界限,深刻影响着孕产妇行为、医疗决策以及对孕妇的治疗。在孕妇脑死亡这种罕见但棘手的情况下尤其如此,在高依赖护理病房工作的护士和助产士要对怀有活胎的身体得到支持的孕妇进行日常护理。本次讨论围绕针对孕期脑死亡女性形成恰当论述的复杂性展开批判性和伦理论述,并思考在此背景下护士和助产士照顾该女性/身体/胎儿的复杂性。研究了在“死亡”身体内生长发育对胎儿的潜在影响,并对文献中缺乏对以此种方式孕育婴儿的长期随访提出质疑。