Information and decision-making process for selective termination of dichorionic pregnancies: some French obstetricians' points of view.
BACKGROUND
In France, neither Bioethics Law nor law related to abortion make reference to selective terminations (ST). Because they apply in the context of multiple pregnancies, ST raises problems which differ from those we usually see in prenatal medicine.We wanted to know: 1) which approaches were used by obstetricians to inform couples about processes and risks of ST, 2) their role in the decision-making process of couples, and 3) their representations about the level of autonomy that couples are able to assume.


METHODS
Qualitative research, eight semi-structured interviews performed with eight obstetricians from seven public hospitals in Parisian region.


RESULTS
Similarities: *Necessity to devote a lot of time to information. *Importance to give the couples the maximum of time for reflection. *Belief that the final decision belongs to couples. Discordances: *Heterogeneity of revealed information. *Discrepancy in the will to assure a complete and non directive information transfer. *Divergence in representations of what is an ethical support. *Differences in the limits of the autonomy of couples.


CONCLUSIONS
All physicians believe that they respect the autonomy of couples, arguing that final decision belongs to them. Paradoxically, some results are indicative of a sizeable level of directiveness from the physicians.
Legendre
Claire-Marie
CM
Laboratoire d'éthique médicale, et de médecine légale et réseau de recherche en éthique INSERM, 45 rue des St-Pères, 75006 Paris, France.
Hervé
Christian
C
Goussot-Souchet
Michèle
M
Bouffard
Chantal
C
Moutel
Grégoire
G
D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D005602:France; D006801:Humans; D007407:Interviews as Topic; D010817:Physician-Patient Relations; D010920:Placenta; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal / Q000523:psychology*; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D014430:Twins, Monozygotic