ETHICAL CHALLENGES IN CESARIAN SECTION PROCEDURES TO INDICATION OF CONTRACTED PELVIS IN COVID-19 CONFIRMED PATIENTS

Abstract

The COVID-19 pandemic has posed several ethical challenges for all medical personnel. Every doctor always provides the best service to patients and follows the COVID-19 health protocol in handling patients. Ethical issues arise when doctors are faced with a dilemma in handling COVID-19 patients related to human resources, limited facilities, and infrastructure in handling patients in the regional hospital, so the patient must be referred. It was reported an obstetrics case: a 24-year-old patient presented with the first pregnancy, gestational age 39-40 weeks with heartburn complaints, and spotting from the birth canal. The patient was a referral from a regional hospital whose elective cesarean section was planned due to the diagnosis of a contracted pelvis. However, it turns out that the rapid screening test results were reactive to COVID-19 and positive in RT-PCR examination. The medical procedure taken was the immediate termination of pregnancy by a cesarean section that required mental preparation of the patient, family, and a team of doctors. The formation of a multidisciplinary team of doctors, the preparation of tools and places for postoperative care for mothers and babies, provide information to patients and families, informed consent, special needs of mothers and babies is an ethical challenge that needs to be addressed carefully. In cases of pregnancy termination in COVID-19 patients, the ethical challenge is its appeal, which should find a solution using clinical ethics theory and the basic principle of medical ethics.