Frank A Chervenak*,Laurence B McCullough
Objective: To describe the professional responsibility model of ethics in perinatal medicine, based on the fetus and pregnant woman as patients, to guide the deliberative practice of perinatal medicine. Methods: We describe secular medical ethics and its two fundamental principles, beneficence and respect for autonomy. We articulate the ethical concept of the fetus as a patient on the basis of the ethical principle of beneficence. Results: In the deliberative practice of perinatal medicine guided by the professional responsibility model, the perinatologist should always identify and balance beneficence-based obligations to the fetal patient and beneficence-based and autonomy-based obligations to the pregnant patient. Directive counseling is appropriate when the fetus is a patient. Non-directive counseling is appropriate when the fetus is not a patient. Conclusion: Counseling pregnant women about the clinical management of their pregnancies should always identify and balance beneficence-based obligations to the fetal patient and beneficence-based and autonomy-based obligations to the pregnant patient.
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