An ethically justified decision-making pathway for the management of pregnancies complicated by twin-to-twin transfusion syndrome.
OBJECTIVE
To present an ethically justified decision-making pathway to use in the evaluation and treatment of pregnant women whose fetuses have twin-to-twin transfusion syndrome (TTTS).


METHODS
The ethical principles of beneficence, autonomy and professional integrity were applied to the diagnostic and treatment options for TTTS.


RESULTS
An algorithm was developed that includes the use of directive and non-directive counseling which can be used as a guide for informed consent of women whose pregnancies have TTTS.


CONCLUSIONS
Ethics is an essential component of decision making for both pregnant women and their obstetricians in pregnancies complicated by TTTS.
Skupski
Daniel
D
Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA. dwskupsk@med.cornell.edu <dwskupsk@med.cornell.edu>
Chervenak
Frank A
FA
McCullough
Laurence
L
D000025:Abortion, Eugenic / Q000941:ethics; D003657:Decision Making / Q000941:ethics*; D019468:Disease Management; D005260:Female; D005330:Fetofetal Transfusion / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D011247:Pregnancy; D014427:Twins / Q000941:ethics*