title: Healthcare justice and human rights in perinatal medicine.
abstract: This article describes an approach to ethics of perinatal medicine in which "women and children first" plays a central role, based on the concept of healthcare justice. Healthcare justice requires that all patients receive clinical management based on their clinical needs, which are defined by deliberative (evidence-based, rigorous, transparent, and accountable) clinical judgment. All patients in perinatal medicine includes pregnant, fetal, and neonatal patients. Healthcare justice also protects the informed consent process, which is intended to empower the exercise of patient autonomy in the decision-making process about patient care. In the context of healthcare justice, the informed consent process should not be influenced by ethically irrelevant factors. Healthcare justice should be understood as a basis for the human rights to healthcare and to participate in decisions about one's healthcare. Healthcare justice in perinatal medicine creates an essential role for the perinatologist to be an effective advocate for pregnant, fetal, and neonatal patients, i.e., for "women and children first."
authors.affiliation: Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY. 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.
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D002648:Child; D003657:Decision Making / Q000941:ethics*; D026689:Ethical Analysis; D004992:Ethics, Medical; D005260:Female; D046128:Fetal Therapies / Q000941:ethics*; D005328:Fetal Viability / Q000502:physiology*; D006806:Human Rights; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D018743:Perinatal Care / Q000941:ethics; D026684:Personal Autonomy; D011247:Pregnancy; D012935:Social Justice / Q000941:ethics
keywords: Healthcare justice; Human rights; Perinatal ethics; Women and children first