title: Responding to refusal of recommended cesarean section: Promoting good parenting.
abstract: Consideration of what a "good parent" would do in controversial perinatal cases has been largely absent from to ethics literature. This article argues when a cesarean section is required to prevent death or serious disability for a fetus, the pregnant woman has an ethical (although not legal) obligation to undergo that procedure even when she has concerns or conflicting commitments. Further, a clinician may be justified in using persuasive counseling when there is grave harm at stake that the patient has a moral obligation to prevent. This conclusion is tested by exploring its implications in several other analogous controversial contexts.
authors.affiliation: Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 310D, MS 420, Houston, TX 77030. Electronic address: janet.malek@bcm.edu.
authors.forename: Janet
authors.initials: J
authors.lastname: Malek
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002585:Cesarean Section / Q000941:ethics / Q000331:legislation & jurisprudence; D003657:Decision Making; D037001:Directive Counseling / Q000941:ethics; D026689:Ethical Analysis; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D007231:Infant, Newborn; D007258:Informed Consent / Q000941:ethics* / Q000523:psychology; D008297:Male; D033261:Maternal-Fetal Relations / Q000523:psychology; D028681:Moral Obligations; D016487:Parenting / Q000523:psychology*; D026684:Personal Autonomy; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D016312:Treatment Refusal / Q000941:ethics / Q000331:legislation & jurisprudence
keywords: Cesarean delivery; Ethics; Good parenting; Persuasive counseling