Brenner B, Burnet P
North Shore Hospital, Takapuna, Auckland.
N Z Med J. 1995 Oct 27;108(1010):431-2.
A case is presented where the Courts have authorised an obstetric intervention deemed necessary for the well-being of both mother and child. Although the case is one of maternal psychosis, there are legal and ethical concerns whenever court-ordered intervention is deemed necessary. Approaches to this difficult medical decision making problem in the form of utilitarian "burdens v benefit" ratio analysis or the recognised traditional ethical principles of beneficence, nonmaleficence, justice and acting in the patient's best interest are considered. The Royal College of Obstetricians and Gynaecologists guidelines suggesting "that it is inappropriate ... to invoke judicial intervention to overrule an informed and competent woman's refusal of a proposed medical treatment, even though her refusal might place her life and that of her fetus at risk" are questioned.
本文呈现了一个案例，在此案例中，法院批准了一项被认为对母婴健康均有必要的产科干预措施。尽管该案例涉及产妇精神病，但每当法院下令进行必要干预时，都会引发法律和伦理方面的担忧。文中考虑了以功利主义的“负担与益处”比率分析，或公认的传统伦理原则（即行善、不伤害、公正以及为患者的最大利益行事）等形式来解决这一艰难的医疗决策问题。皇家妇产科学院的指南提出“即使一名明智且有行为能力的女性拒绝接受提议的医疗治疗可能会危及她自己和胎儿的生命，但援引司法干预来推翻她的拒绝是不合适的”，这一观点受到了质疑。
