Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
Anesthesiol Clin. 2024 Sep;42(3):491-502. doi: 10.1016/j.anclin.2023.12.007. Epub 2024 Feb 28.
Anesthesia clinicians often navigate a delicate balance between maternal and fetal safety. Interventions for at fetal well-being may introduce risks of harm to the mother and raise ethical dilemmas. Emergency procedures often focus on direct fetal safety, sidelining maternal physical and mental well-being. The clash between ethical principles, particularly nonmaleficence and beneficence, often arises, with maternal autonomy guiding decisions. Fetal surgery exemplifies risking maternal health for fetal benefit, whereas emergent cesarean deliveries pose physical and psychological challenges for both the mother and child.
麻醉科医生在保障母婴安全方面常常需要权衡。为了胎儿的健康而采取的干预措施可能会给母亲带来伤害风险,并引发伦理困境。紧急程序通常侧重于直接保障胎儿安全,而忽视了母亲的身心健康。此时,常常会出现伦理原则之间的冲突,特别是不伤害和受益原则,而产妇自主权则指导着决策。为了胎儿的利益而冒险母亲的健康就是胎儿手术的例子,而紧急剖宫产则会给母亲和孩子带来身体和心理上的挑战。