Ethical implications for early pregnancy of the fetus as patient: a basic ethical concept in fetal medicine.

The viable fetus is a patient. The previable fetus, including the in vitro embryo and the near-viable fetus, is a patient solely as a function of the exercise of the woman's autonomy. Directive counseling of the pregnant woman for fetal benefit is appropriate only when the fetus is a patient and must take account of the presence and severity of anomalies, extreme prematurity and beneficence-based and autonomy-based obligations to the pregnant woman.