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Ethical Dilemmas Related to Foetal Diagnosis and Foetocide

Received: 20 July 2021     Accepted: 5 August 2021     Published: 18 August 2021
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Abstract

Ethics is an essential dimension of obstetrics and gynaecology and helps balance beneficence and autonomy-based obligations with professional conscience ensuring respect for the pregnant woman’s autonomy. The Law defines what can be offered in our country and guides the obstetrician as well as the parents. In South Africa termination of pregnancy is legal. A woman can request termination of her pregnancy up until 12weeks if she chooses so. The South African law allows termination of a pregnancy up to 20weeks and beyond 20weeks if there are significant reasons for this to be requested or offered. The question of what foetal abnormalities are considered significant and therefore should be considered for termination has led to ongoing discussions and debates in various levels of medical and legal societies. The obstetrician has the right to exercise his or her own autonomy in dealing with these situations. Exercise of autonomy by a patient cannot justifiably oblige a physician to act in a way that is unacceptable as a matter of his/her individual conscience. Citing case laws, the Courts in the country are asked to decide on “wrongful birth”- which would require a Court to determine whether a child should have been born. The South African Constitutional Court in a recent ruling determined that "this goes to the heart of what it is to be human, something that should not be asked of the law". Medical and legal societies need to work together and help guide our doctors, our patients and society as to what is ethical and acceptable practice in complex situations where children’s genetic and structural abnormalities alone perhaps should not decide their entire destiny.

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 4)
DOI 10.11648/j.jgo.20210904.15
Page(s) 120-124
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Ethical Dilemmas Related to Foetal Diagnosis and Foetocide

References
[1] Beauchamp T, Childress J. Principles of Biomedical Ethics. 7. New York: Oxford University Press; 2013.
[2] Choice on Termination of Pregnancy Act 92 of 1996. Section 5 (3) and 5 (2).
[3] Constitution of the Republic of South Africa, 1996 - Chapter 2 (27-28): Bill of Rights.
[4] Chevernak FA, McCullough LB. The Ethics of Feticide. Fet Mat Med Rev. 2007; 18: 289-309.
[5] Nicolaides, KH, Campbell, S, Gabbe, SG, Guidetti, R. Ultrasound Screening for Spina Bifida: Cranial and Cerebral Signs. Lancet 1986; 2: 72–74.
[6] Evans, MI, Dommergues, M, Wapner, R, Lynch, L, Dumez, Y, Goldberg, JD et al. Efficacy of transabdominal multifetal pregnancy reduction: collaborative experience among the world's largest centers. Obstet Gynecol 1993; 82: 61–67.
[7] Evans, MI, Johnson, MP, Quintero, RA, Fletcher, JC. Ethical issues surrounding multifetal pregnancy reduction and selective termination. Clin Perinat 1996; 23: 437–51.
[8] Keymanthri Moodley. The ethics of Feticide and late termination of pregnancy. South African Journal of Obstetrics and Gynaecology 2008 14 (1): 28.
[9] K Moodley. Ethics; Feticide; Late termination of pregnancy O & G Forum Vol. 18 (3) 2008: pp. 93-95.
[10] Chervenak, FA, McCullough, LB. The limits of viability. 1997; J Perinat Med 25: 418–20.
[11] Rosemarie Tong Department of Philosophy. University of North Carolina at Charlotte, Charlotte, USA Cambridge University Press 2002; Chapter 5: 87-100.
[12] Fetal Pain: A Systematic Multidisciplinary Review of the Evidence. JAMA 2005; 294: 947-954.
[13] Ethical issues in Maternal and Fetal Medicine, Donna L Dickenson, Cambridge University press 2002.
[14] Genome: the Autobiography of a Species in 23 Chapters. Matt Ridley 2002.
[15] The Care of Women requesting induced abortion, Evidence-based Clinical Guideline Number 7, RCOG, 2004.
Cite This Article
  • APA Style

    Ermos Nicolaou. (2021). Ethical Dilemmas Related to Foetal Diagnosis and Foetocide. Journal of Gynecology and Obstetrics, 9(4), 120-124. https://doi.org/10.11648/j.jgo.20210904.15

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    ACS Style

    Ermos Nicolaou. Ethical Dilemmas Related to Foetal Diagnosis and Foetocide. J. Gynecol. Obstet. 2021, 9(4), 120-124. doi: 10.11648/j.jgo.20210904.15

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    AMA Style

    Ermos Nicolaou. Ethical Dilemmas Related to Foetal Diagnosis and Foetocide. J Gynecol Obstet. 2021;9(4):120-124. doi: 10.11648/j.jgo.20210904.15

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  • @article{10.11648/j.jgo.20210904.15,
      author = {Ermos Nicolaou},
      title = {Ethical Dilemmas Related to Foetal Diagnosis and Foetocide},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {9},
      number = {4},
      pages = {120-124},
      doi = {10.11648/j.jgo.20210904.15},
      url = {https://doi.org/10.11648/j.jgo.20210904.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210904.15},
      abstract = {Ethics is an essential dimension of obstetrics and gynaecology and helps balance beneficence and autonomy-based obligations with professional conscience ensuring respect for the pregnant woman’s autonomy. The Law defines what can be offered in our country and guides the obstetrician as well as the parents. In South Africa termination of pregnancy is legal. A woman can request termination of her pregnancy up until 12weeks if she chooses so. The South African law allows termination of a pregnancy up to 20weeks and beyond 20weeks if there are significant reasons for this to be requested or offered. The question of what foetal abnormalities are considered significant and therefore should be considered for termination has led to ongoing discussions and debates in various levels of medical and legal societies. The obstetrician has the right to exercise his or her own autonomy in dealing with these situations. Exercise of autonomy by a patient cannot justifiably oblige a physician to act in a way that is unacceptable as a matter of his/her individual conscience. Citing case laws, the Courts in the country are asked to decide on “wrongful birth”- which would require a Court to determine whether a child should have been born. The South African Constitutional Court in a recent ruling determined that "this goes to the heart of what it is to be human, something that should not be asked of the law". Medical and legal societies need to work together and help guide our doctors, our patients and society as to what is ethical and acceptable practice in complex situations where children’s genetic and structural abnormalities alone perhaps should not decide their entire destiny.},
     year = {2021}
    }
    

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Author Information
  • Division of Maternal and Foetal Medicine, University of the Witwatersrand, Johannesburg, South Africa

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