Samples Stefani, Gandhi Rupali, Woo Joyce, Patel Angira
Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Division of Pediatric Cardiology, Advocate Christ Children's Hospital, Oak Lawn, IL 60453, USA.
J Cardiovasc Dev Dis. 2024 Jun 1;11(6):172. doi: 10.3390/jcdd11060172.
Fetal cardiology has evolved over the last 40 years and changed the timing of diagnosis and counseling of congenital heart disease, decision-making, planning for treatment at birth, and predicting future surgery from the postnatal to the prenatal period. Ethical issues in fetal cardiology transect multiple aspects of biomedical ethics including improvement in prenatal detection and diagnostic capabilities, access to equitable comprehensive care that preserves a pregnant person's right to make decisions, access to all reproductive options, informed consent, complexity in shared decision-making, and appropriate use of fetal cardiac interventions. This paper first reviews the literature and then provides an ethical analysis of accurate and timely diagnosis, equitable delivery of care, prenatal counseling and shared decision-making, and innovation through in utero intervention.
在过去40年里，胎儿心脏病学不断发展，改变了先天性心脏病的诊断和咨询时机、决策方式、出生时的治疗规划，以及从产后到产前对未来手术的预测。胎儿心脏病学中的伦理问题贯穿生物医学伦理的多个方面，包括产前检测和诊断能力的提高、获得公平的综合护理以维护孕妇的决策权、获得所有生殖选择、知情同意、共同决策的复杂性，以及胎儿心脏干预的合理使用。本文首先回顾文献，然后对准确及时的诊断、公平的护理提供、产前咨询和共同决策，以及通过子宫内干预进行创新进行伦理分析。
