Leiberman J R, Frenkel D A, Mazor M, Biale Y, Insler V
Isr J Med Sci. 1984 Nov;20(11):1051-5.
Modern diagnostic methods reveal an increased number of cases of gross fetal malformations, and physicians are faced with serious ethical considerations. The disclosure of data during conversations with the parents, the decision-making process and the different courses of action are discussed. Cases with defined diagnoses may be divided into three different clinical situations: 1) a malformation incompatible with extrauterine life; 2) increasing organ damage caused by a fetal defect; and 3) a severely handicapped fetus capable of short- or long-term survival. The recent concept of fetal abuse is emphasized. When pregnancy is allowed to continue to term in these cases, psychological and social aspects must be taken into consideration. Medical assessment, ethicolegal norms, and religious beliefs of parents and physicians should guide the course of action. We believe that the medical team should perform late termination of pregnancy when justified and approved by a court or a statutory committee.
现代诊断方法显示出胎儿严重畸形的病例数量有所增加，医生面临着严峻的伦理考量。文中讨论了在与父母交谈过程中的数据披露、决策过程以及不同的行动方案。已明确诊断的病例可分为三种不同的临床情况：1）一种与宫外生存不相容的畸形；2）由胎儿缺陷导致的器官损害不断加重；3）一个能够短期或长期存活的严重残疾胎儿。文中强调了近期关于胎儿虐待的概念。在这些情况下，如果允许妊娠持续至足月，则必须考虑心理和社会方面的因素。父母和医生的医学评估、伦理法律规范以及宗教信仰应指导行动过程。我们认为，当有正当理由并经法院或法定委员会批准时，医疗团队应实施晚期妊娠终止。
