title: Ethical challenges in the management of multiple pregnancies: the professional responsibility model of perinatal ethics.
abstract: Abstract Ethics is an essential component for the responsible clinical management of multiple gestation and decision-making about such pregnancies with pregnant women. The ethical concept of the fetus as a patient is presented as the basis for identifying a professionally responsible approach to selective termination, twin-to-twin transfusion syndrome, and to discordant beneficence-based obligations that exist when one or more fetuses are adversely affected by a fetal anomaly or complication of pregnancy. The roles for directive counseling, i.e., making evidence-based recommendations, and for non-directive counseling, i.e., offering evidence-based alternatives but making no recommendations, are described. The professional responsibility model of perinatal ethics creates a practical framework to guide the clinical judgment of perinatologists and the informed process about the clinical management of multiple pregnancies.
authors: Department of Obstetrics and Gynecology, Weill Medical College of Cornell University New York, New York, NY, USA. fac2001@med.cornell.edu
authors: Frank A
authors: FA
authors: Chervenak
authors: Laurence B
authors: LB
authors: McCullough
mesh_terms: D003657:Decision Making / Q000941:ethics*; D026689:Ethical Analysis; D004992:Ethics, Medical; D005260:Female; D005330:Fetofetal Transfusion / Q000628:therapy*; D005333:Fetus; D006801:Humans; D009774:Obstetrics / Q000941:ethics*; D011247:Pregnancy; D011272:Pregnancy, Multiple