Ethics in Obstetric Ultrasound: The Past 25 Years in Perspective

Chervenak, Frank A.; McCullough, Laurence B.

doi:10.5005/jp-journals-10009-1181

Cited by 2 publications

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PMDs and the Moral Specialness of Medicine: An Analysis of the ‘Keepsake Ultrasound’

Smajdor

Stöckl

2017

Quantified Lives and Vital Data

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PMDs raise questions about the relationship between morality and medicine, threatening the conceptual discreteness of medicine itself. Everyday items such as phones or watches are increasingly used for quasi-medical purposes. Conversely, products designed for medical use are entering marketplaces and being used in ways that serve users’ values and interests without mapping neatly onto established paradigms of medical need and authority. One example of this is the so-called keepsake ultrasound. When sought outside routine medical care, our lack of ability to monitor and regulate these scans raises ethical challenges. Devices or procedures such as keepsake ultrasounds, which can have both medical and non-medical applications and which can be used by both medical professionals and members of the public, thus raise new questions for regulatory authorities

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PMDs and the Moral Specialness of Medicine: An Analysis of the ‘Keepsake Ultrasound’

Smajdor

Stöckl

2017

Quantified Lives and Vital Data

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Ultrasound’s ‘window on the womb’ brings ethical challenges for balancing maternal and fetal health interests: obstetricians’ experiences in Australia

et al. 2015

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BackgroundObstetric ultrasound has become a significant tool in obstetric practice, however, it has been argued that its increasing use may have adverse implications for women’s reproductive freedom. This study aimed to explore Australian obstetricians’ experiences and views of the use of obstetric ultrasound both in relation to clinical management of complicated pregnancy, and in situations where maternal and fetal health interests conflict.MethodsA qualitative study was undertaken as part of the CROss-Country Ultrasound Study (CROCUS). Interviews were held in November 2012 with 14 obstetricians working in obstetric care in Victoria, Australia. Data were analysed using qualitative content analysis.ResultsOne overall theme emerged from the analyses: The ethical challenge of balancing maternal and fetal health interests, built on four categories: First, Encountering maternal altruism’ described how pregnant women’s often ‘altruistic’ position in relation to the health and wellbeing of the fetus could create ethical challenges in obstetric management, particularly with an increasing imbalance between fetal benefits and maternal harms. Second, ‘Facing shifting attitudes due to visualisation and medico-technical advances’ illuminated views that ultrasound and other advances in care have contributed to a shift in what weight to give maternal versus fetal welfare, with increasing attention directed to the fetus. Third, ‘Guiding expectant parents in decision-making’ described the difficult task of facilitating informed decision-making in situations where maternal and fetal health interests were not aligned, or in situations characterised by uncertainty. Fourth, ‘Separating private from professional views’ illuminated divergent views on when the fetus can be regarded as a person. The narratives indicated that the fetus acquired more consideration in decision-making the further the gestation progressed. However, there was universal agreement that obstetricians could never act on fetal grounds without the pregnant woman’s consent.ConclusionsThis study suggests that medico-technical advances such as ultrasound have set the scene for increasing ethical dilemmas in obstetric practice. The obstetricians interviewed had experienced a shift in previously accepted views about what weight to give maternal versus fetal welfare. As fetal diagnostics and treatment continue to advance, how best to protect pregnant women’s right to autonomy requires careful consideration and further investigation.

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Ethics in Obstetric Ultrasound: The Past 25 Years in Perspective

Cited by 2 publications

References 20 publications

PMDs and the Moral Specialness of Medicine: An Analysis of the ‘Keepsake Ultrasound’

PMDs and the Moral Specialness of Medicine: An Analysis of the ‘Keepsake Ultrasound’

Ultrasound’s ‘window on the womb’ brings ethical challenges for balancing maternal and fetal health interests: obstetricians’ experiences in Australia

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