Obstetrical delivery of the HIV-positive woman: legal and ethical considerations.
Every year, thousands of perinatally HIV-infected children are born, resulting in debate about appropriate HIV treatment and interventions for pregnant women. Recent medical studies endorse the use of the cesarean delivery to reduce vertical (mother to infant) transmission of HIV. In addition to medical questions, this practice raises legal and ethical considerations for the attending physician. In the context of AIDS prevention, the potential exists for reasoned and well-informed decision making to give way to encouragement, and even duress, in cases where a woman refuses recommended surgical delivery. However, in such cases, the role of the physician should remain as that of an informed educator and counselor, enabling the patient to exercise her autonomy and personal choice within her social and cultural context.
University of Toronto Faculty of Law, Ontario, Canada. sscarrow@uwo.ca
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D002585:Cesarean Section / Q000592:standards* / Q000706:statistics & numerical data; D003657:Decision Making; D036861:Delivery, Obstetric / Q000379:methods; D004992:Ethics, Medical; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007258:Informed Consent; D010358:Patient Participation; D011247:Pregnancy; D014481:United States