Does obstetric ethics have any role in the obstetrician's response to the abortion controversy?
We defend the view that the obstetrician's response to the abortion controversy cannot be based on accounts of the independent moral status of the fetus, because all such accounts are irresolvably disputable. That response, however, can be based on an account of the dependent moral status of the fetus. For such an account the central question is, "When is the fetus a patient?" Viable fetuses are patients. Nonviable third-trimester fetuses are not patients. Previable fetuses are patients solely as a function of the woman's autonomous decision to confer such status. The abortion of a viable fetus is, with few exceptions, never ethically justified, because it is a patient. The abortion of nonviable third-trimester fetuses (i.e., premature termination of pregnancy) is justified when the pregnant women consents to it. Abortion of the previable fetus is justifiable when the pregnant women consents to it. We distinguish between professional and private conscience. We identify the limits of the former and the legitimate role of the latter, especially in the area of religious beliefs. Finally, we address the implications of our view for residency training programs. The most important of these implications is that requiring all residents to perform abortions is ethically unjustifiable.
Chervenak
F A
FA
Department of Obstetrics and Gynecology, New York Hospital-Cornell Medical Center, NY 10021.
McCullough
L B
LB
D000028:Abortion, Induced / Q000523:psychology*; D001291:Attitude of Health Personnel; D004992:Ethics, Medical / Q000193:education; D005260:Female; D006801:Humans; D007396:Internship and Residency; D009774:Obstetrics / Q000193:education; D010819:Physician's Role; D011247:Pregnancy