title: Ethics in perinatal medicine: A global perspective.
abstract: This article describes the professional responsibility model of perinatal ethics, which requires the perinatologist in all cases to identify and balance beneficence-based and autonomy-based obligations to the pregnant patient, beneficence-based obligations to the fetal patient, and beneficence-based obligations to the neonatal patient. We explain how this model avoids the clinical failure of both fetal and maternal rights-based reductionism, i.e., insistence either on unlimited fetal rights or on unlimited maternal rights, respectively. The professional responsibility model of perinatal ethics provides the basis for the transnational clinical ethical concept of healthcare justice, which requires that beneficence-based obligations to all patients be routinely fulfilled by providing them with an evidence-based standard of care. We then show how healthcare justice can be used to identify and address ethically unacceptable allocation of healthcare resources. The professional responsibility model of perinatal ethics creates an important role for the perinatologist as responsible advocate for pregnant, fetal, and neonatal patients.
authors.affiliation: Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA. Electronic address: fac2001@med.cornell.edu.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Chervenak
authors.affiliation: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D026686:Beneficence; D019317:Evidence-Based Medicine; D005260:Female; D006806:Human Rights; D006801:Humans; D009774:Obstetrics / Q000941:ethics*; D026684:Personal Autonomy; D011247:Pregnancy; D024382:Professional Role; D012935:Social Justice; D012941:Social Responsibility
keywords: Autonomy; Beneficence; Healthcare justice; Perinatal ethics; Professional responsibility