Ethical issues in gynecology.

The authors apply the language and concepts of ethics to the problem of differences between the gynecologist and the patient about what is in the patient's interest. We develop a framework for clinical judgment and decision making about the ethical dimensions of the gynecologist-patient relationship. To achieve this goal we define the ethical principles of beneficence and respect for autonomy. We then show how these two principles interact in clinical judgement and decision making using common examples from gynecologic practice. We examine factors that influence the relative weight of these principles, including subject matter, probability of net medical benefit, availability of reasonable alternatives, and ability of the patient to participate in the informed consent process.