title: Ethical issues in cesarean delivery.
abstract: Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery. This chapter emphasizes a preventive ethics approach, designed to prevent ethical conflict in clinical practice. To achieve this goal, a preventive ethics approach uses the informed consent process to offer cesarean delivery as a medically reasonable alternative to vaginal delivery, to recommend cesarean delivery, and to recommend against cesarean delivery. The limited role of shared decision making is also described. The professional responsibility model of obstetric ethics guides this multi-faceted preventive ethics approach.
authors.affiliation: New York Presbyterian Hospital, 525 East 68th Street, M-724, Box 122, New York, NY 10065, USA; Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, 525 East 68th Street, M-724, Box 122, New York, NY 10065, USA. Electronic address: fac2001@med.cornell.edu.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Chervenak
authors.affiliation: Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, 525 East 68th Street, M-724, Box 122, New York, NY 10065, USA. Electronic address: Laurence.McCullough@bcm.edu.
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D002585:Cesarean Section / Q000941:ethics*; D003657:Decision Making; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007258:Informed Consent; D007743:Labor, Obstetric; D057240:Patient Preference; D011247:Pregnancy; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000941:ethics*
keywords: cesarean delivery; cesarean delivery on request; professional responsibility model of obstetric ethics; trial of labor after cesarean delivery