Ethical issues surrounding multifetal pregnancy reduction and selective termination.
MFPR and selective terminations satisfy the criteria of enabling pregnancies to continue with the least harm and most benefits to all involved. The surviving infants can be saved from certain death (abortion) or higher risks of severe harm and death and of an extended stay in neonatal intensive care (premature delivery). In the hands of trained operators, MFPR and selective termination is, in our opinion, the best means to protect the mother's health and well-being, given it is available and approved by the parents. MFPR and selective termination avoid the trauma of abortion of a wanted pregnancy, enable the parents to achieve the goal of having their own child, and avoid the dangers of delivery of multiple premature infants. There is no doubt that any procedure that involves the death of a fetus will be hotly argued despite the potential for greater good. We acknowledge that it will be impossible to convince those who cannot morally accept the taking of any life regardless of the circumstances. We hope, however, that we have shown there is a place for MFPR and selective termination in a very limited number of circumstances and the ethical probity of MFPR and selective termination as an option in such cases.
Evans
M I
MI
Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Michigan, USA.
Johnson
M P
MP
Quintero
R A
RA
Fletcher
J C
JC
D000013:Congenital Abnormalities; D004200:Diseases in Twins; D004992:Ethics, Medical; D005260:Female; D030342:Genetic Diseases, Inborn; D006801:Humans; D028681:Moral Obligations; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal; D011272:Pregnancy, Multiple; D037841:Pregnant People; D018570:Risk Assessment; D012732:Sex Determination Analysis; D014481:United States