Monday, January 28, 2008

Ethics

A lot of ethical issues come up with perinatal and neonatal care. For example, how do you treat a pregnant woman if the standard of care is a drug whose effects on the fetus are unknown? How much are you willing to endanger a mother's life to save the fetus? Can you compel a mother to undergo something as invasive as a C-section because you feel obligated to save the life of an unborn baby? What happens when a mother denies her fetus important life-saving treatments or tests, such as antiretroviral drugs because she has HIV? Issues around genetics are just as dicey. What are a physician's obligations to a patient's family after diagnosing a patient with a potentially genetically transmissible disease? Can you balance confidentiality of the patient's condition with an obligation to warn children if it is preventable? Can parents force their children to undergo genetic testing? How about genetic testing for a carrier condition?

There are so many interesting ethical dilemmas and I actually enjoy these small groups where we try to flesh out how to apply general principles of autonomy, beneficence, non-maleficence, justice. I'm not sure we can come to very strong conclusions, but I do think discussion of these issues helps us understand the impact of these real-world situations.

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