Documenting moral agency: a qualitative analysis of abortion decision making for fetal indications.
OBJECTIVE
We explored whether the decision-making process of women aborting a pregnancy for a fetal indication fit common medical ethical frameworks.


METHODS
We applied three ethical frameworks (principlism, care ethics, and narrative ethics) in a secondary analysis of 30 qualitative interviews from women choosing 2nd trimester abortion for fetal indications.


RESULTS
All 30 women offered reasoning consistent with one or more ethical frameworks. Principlism themes included avoidance of personal suffering (autonomy), and sparing a child a poor quality of life and painful medical interventions (beneficence/non-maleficence). Care ethics reasoning included relational considerations of family needs and resources, and narrative ethics reasoning contextualized this experience into the patient's life story.


CONCLUSIONS
This population's universal application of commonly accepted medical ethical frameworks supports the position that patients choosing fetal indication abortions should be treated as moral decision-makers and given the same respect as patients making decisions about other medical procedures.


CONCLUSIONS
These findings suggest recent political efforts blocking abortion access should be reframed as attempts to undermine the moral decision-making of women.
University of Utah School of Medicine, Department of Obstetrics and Gynecology, 30N 1900E Rm 2B-200, Salt Lake City, UT 84132. Electronic address: lori.gawron@hsc.utah.edu.
Lori M
LM
Gawron
Northwestern University Feinberg School of Medicine, Department of Medical Humanities and Bioethics, Rubloff Building Suite 625, 750N Lakeshore Dr, Chicago, IL 60611. Electronic address: k-watson@northwestern.edu.
Katie
K
Watson
D000028:Abortion, Induced / Q000941:ethics; D000328:Adult; D003657:Decision Making / Q000941:ethics*; D004992:Ethics, Medical; D005260:Female; D005315:Fetal Diseases; D006801:Humans; D009014:Morals; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011788:Quality of Life
Abortion; Fetal anomaly; Medical ethics; Stigma