[Iatrogenic fetal death--ethical and juridical issues].
What are the rights of a fetus to live and exist? Is respecting the rights of the pregnant woman over her body and her independence the primary concern to be taken into account? Or does the fetus of a certain age have it's own rights, which should prevail when cardinal decisions about it's future life need to be made? How should the parturient's doctor act when contradicting interests and needs exist between those of the pregnant woman and her fetus? To whom does the practitioner owe his or her primary loyalty? Can any of the involved "parties" prosecute the physician for acting on behalf of one of them, while injuring the rights of the other? In the great majority of cases, the above presented dilemmas do not need to be dealt with, as there is a complete overlap between the expectations of the future mother and the interests of her future child. Indeed the legislator attended to these issues, and considered the medical risks, the ethical and juridical aspects, and the philosophical theories and religious beliefs. However, a few difficult cases with no authoritative recommendations or guidance still exist. Our case report is an example of such a dilemma, in which the rights of a fetus at term, with presumed normal anatomical and intellectual potential, were scarified and violated, causing it's death. This dismal outcome is apparently the consequence of the mother's intellectual incompetence. At the same time, the medical and juridical institutions backed up her refusal to have a cesarean section that could have saved her fetus, considering her (incompetent) decision as prevailing, leaving the fetus to perish in its mother's womb, and trampling irrevocably it's right to live. In view of this case, we describe the chain of events that took place, involving the reader in the medical-ethical-juridical dilemmas. We intend to bring the subject to an overall profound, valuable, professional and multidisciplinary debate in order to establish acceptable guidance and directives in similar cases in the future.
Rothbart
Haim
H
Strulov
Avshalom
A
D005260:Female; D005313:Fetal Death; D006801:Humans; D007049:Iatrogenic Disease; D007557:Israel; D007883:Legislation, Medical; D011247:Pregnancy