Bioethical Controversies in Pediatric Cardiology and Cardiac Surgery by Constantine Mavroudis & J. Thomas Cook & Constantine D. Mavroudis

Author:Constantine Mavroudis & J. Thomas Cook & Constantine D. Mavroudis
Language: eng
Format: epub
ISBN: 9783030356606
Publisher: Springer International Publishing

6 Conclusion

Ethically and legally, abortion is a complex and difficult issue. The decision to terminate or to continue a pregnancy after positive diagnosis of a congenital heart defect has all of the usual issues related to abortion, plus more. Such a decision involves: the offspring’s suffering and ultimate quality of life; the burdens on the family; a woman’s right to make decisions about her body; loss, grief and disappointment. Thinking about the decision may require asking just what the status of this fetal entity is—a living human being, but not a person; soon-to-be-viable, but currently dependent on another for life support; potentially “one of us,” but severely compromised in its prospects; capable of acquiring conscious self-awareness, but currently unaware that it exists at all, and hence unaware that it has anything to lose. Confused by the complexities and stirred by religious and near-religious fervor on both sides, our political system has produced a tangle of state laws (some in force and some under challenge), federal legislation and regulation, and court decisions (in force and under appeal). There is reason to fear that that legal thicket is soon to become more tangled still. And finally, the very fact that there is zealous polarization and no consensus gives rise to additional sources of concern for the mother who has decisions to make—concerns about social stigma, about the awful things she reads on the internet, about the implicit moral condemnation should her hospital or physician be among the many who refuse to participate in abortions.

In this confusing context the conscientious physician should focus on the obligation to respect the autonomy of the patient. The patient, at this pre-viability stage, is the pregnant woman. Her right to privacy and self-determination governs the scenario, and if the interests of the fetus come into consideration, she is (as parent) the decision-maker regarding that fetus’s interests. The physician must provide the most complete and accurate information that she can, conveying (where possible) that all legal options are morally and medically acceptable.

References

1.

Riddle JM. Contraception and abortion from the ancient world to the renaissance. Cambridge: Harvard University Press; 1992.

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