Reproductive Ethics Flashcards
When working with a pregnant patient who has refused medically recommended treatment, the following principles should be considered:
- Reliability and validity of evidence base
- Severity of prospective outcome
- Degree of burden or risk on patient
- Extent to which patient understands risks involved for herself and her fetus
- Degree of urgency that the case presents
It is not ethically defensible to invoke ___ as a justification to attempt to persuade a patient into accepting care she does not desire.
It is not ethically defensible to invoke conscience as a justification to attempt to persuade a patient into accepting care she does not desire.
Any fetal intervention has . . .
. . . implications for the pregnant woman’s health and necessarily her bodily integrity, and therefore cannot be performed without her explicit informed consent.
When the pregnant woman and fetus are conceptualized as separate patients, . . .
. . . the medical interests, health needs, and rights of the woman may come secondary to those of the fetus at times.
The OBGYN College officially endorsed ethical approach to pregnant woman-fetal care is . . .
that the primary duty of the physician is to the pregnant woman, not to her fetus
The physician has beneficence-based motivation to care for the fetus, but a beneficence-based obligation to care for the pregnant woman.
Questions of how to care for a fetus cannot be ___.
Questions of how to care for a fetus cannot be a simple cost-benefit analysis for the fetus and the woman.
They must respsect individual values and the pregnant woman’s autonomy and control over her own body.
Directive counciling
Patient counseling in which the OBGYN physician plays an active role in the patient’s decision making by offering guidance, advice, recommendations, or some mixture thereof.
This definition is used to make in juxtaposition to coercion
An OBGYN physician may not utilize arguments involving ____ to advise a pregnant woman, as this falls into the realm of coercion.
An OBGYN physician may not utilize arguments involving terms of duress or references to courts or child protective services to advise a pregnant woman, as this falls into the realm of coercion.
The OBGYN should affirm . . .
. . . the importance of a pregnant woman’s assessment of her relational interests (personal, familial, social, community).
The OBGYN world is frought with ___.
The OBGYN world is frought with prognostic uncertainty.
Things a physician must keep in mind when discussing reproductive ethics with a patient
- Limitations of the patient’s understanding
- Prognostic uncertainty
- Different cultural or social values
- Language barriers
- Power dynamics
When a pregnant woman refuses medical treatment, the physician must. . .
When a pregnant woman refuses medical treatment, the physician must document this refusal in the medical record, including all aspects of informed dissent, and the patient’s reason for refusal.
At all costs, OBGYN physicians should avoid ___.
At all costs, OBGYN physicians should avoid court orders for interventions.
RESPECT communication model
- Rapport
- Empathy
- Support
- Partnership
- Explanations
- Cultural competence
- Trust
Presumptive consent
Used as a defense for critically needed emergency care, often when the patient is anesthetised mid-procedure. Only applies when the patient has not indicated preference beforehand.
