Pregnant women should receive information about what they might expect to experience during their delivery. Despite this, research shows many women are inadequately prepared for anaesthetic interventions during labour. We surveyed 903 postnatal women across 28 Greater London hospitals about: the analgesic and anaesthetic information that they recalled receiving during pregnancy and delivery; their confidence to make decisions on analgesia; and their satisfaction with the analgesia used. Wide variation was observed between hospitals. Overall, 67 of 749 (9.0%) women recalled receiving antenatal information covering all aspects of labour analgesia, and 108 of 889 (12.1%) covering anaesthesia for caesarean section. Regarding intrapartum information, 256 of 415 (61.7%) respondents recalled receiving thorough information before epidural insertion for labour analgesia, and 102 of 370 (27.6%) before anaesthesia for caesarean section. We found that 620 of 903 (68.7%) women felt well enough informed to be confident in their analgesic choices, and 675 of 903 (74.8%) stated that their analgesia was as expected or better. Receiving information verbally, regardless of provider, was the factor most strongly associated with respondents recalling receiving full information: odds ratio (95%CI) for labour analgesia 20. 66 (8.98-47.53; p < 0.0001); epidural top-up for caesarean section 5. 93 (1.57-22.35; p = 0.01); and general anaesthesia for caesarean section 12. 39 (2.18-70.42; p = 0.01). A large proportion of respondents did not recall being fully informed before an anaesthetic intervention. Collaboration with current antenatal service providers, both in promoting information delivery and providing resources to assist with delivery, could improve the quality of information offered and women's retention of that information.

Many accounts of the morality of abortion assume that early fetuses must all have or lack moral status in virtue of developmental features that they share. Our actual attitudes toward early fetuses don’t reflect this all-or-nothing assumption. If we start with the assumption that our attitudes toward fetuses are accurately tracking their value, then we need an account of fetal moral status that can explain why it is appropriate to love some fetuses but not others. I argue that a fetus can come to have moral claims on persons who have taken up the activity of person-creation.

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The dominant framework for addressing procreative ethics has revolved around the notion of harm, largely due to Derek Parfit's famous non-identity problem. Focusing exclusively on the question of harm treats what procreators owe their offspring as akin to what they would owe strangers (if they owe them anything at all). Procreators, however, usually expect (and are expected) to parent the persons they create, so we cannot understand what procreators owe their offspring without also appealing to their role as prospective parents. I argue that prospective parents can wrong their future children just by failing to act well in their role as parents, whether or not their offspring are ultimately harmed or benefitted by their creation. Their obligations as prospective parents bear on the motivations behind their reproductive choices, including the choice to select for some genetic trait in their offspring. Even when procreators' motivations aren't malicious, or purely selfish, they can still fail to recognize and act for the end of the parental role. Procreators can wrong their offspring by selecting for some genetic trait, then, when doing so would violate their obligations as prospective parents, or when their motivation for doing so is antithetical to the end of the parental role.

Background100% of medical students use Facebook, 88% of whom have viewed a colleague acting unprofessionally on Facebook.1,2 Formal complaints of healthcare professionals acting unprofessionally on social media are rapidly increasing.3,4 However, only 26% of medical students were aware of any relevant advice or guidelines.1,2 Our aim was to increase awareness of the importance of staying professional on Facebook and of how to access support and adviceMethodologyOur simulated tutorial was delivered to clinical medical students on placement in our Trust. Our faculty designed five fictional cases, based on real, high-profile cases, where a medic’s unprofessional use of social media has been investigated. We created a simulated Facebook page for each of the cases. After a tutorial, the students were allocated in small groups to one of the five cases. Once they had prepared their case, they came to a simulated disciplinary hearing, with a mock panel. They presented their case to the panel and the group debated key points.ResultsQuantitative (10-point Likert) and qualitative (free text box) feedback was collected using an anonymous, paper questionnaire. Students (n = 26) feedback a 7.29/10 change in the way that they think about Facebook. Their awareness of what is considered unprofessional increased by 2.15/10 (from 6.26 to 8.42, p-value < 0.0001). Students’ awareness of implications of unprofessional use increased by 2.76/10 (5.53 to 8.30, p-value < 0.0001). There was an increased awareness of 2.88/10 (4.88 to 7.76, p-value < 0.0001) of how to access support and advice. Students who were not aware of their privacy settings stated that they would review them. Comments included; “excellent session, really useful,” “opportunity to apply principles to cases” and “very relevant session, will go and check my profile now!”RecommendationsWe hope to deliver these simulated cases through high-fidelity, simulated disciplinary hearings to further undergraduate and postgraduate students in more trusts.ReferencesRileey B. The Social Media Highway Code, Royal College of General Practitioners. 2013Osman A. Is it time for medicine to update its Facebook status? Br Med J. 2011;343:d6334Rimmer A. Doctors’ concerns over social medical use continue to rise. BMJ Careers 2014Rimmer A. Use of Facebook and Twitter leads to 28 GMC complaints against doctors. BMJ Careers 2014.