严重先天性畸形自愿终止妊娠的伦理困境

Q3 Medicine

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI:10.1016/j.jemep.2025.101084

N.A. Mappaware , T. Irianta , M. Avisha

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引用次数: 0

摘要

背景先天性异常（CA）是由胎儿在子宫内发生的遗传缺陷引起的结构或功能障碍。然而，筛查先天性残疾以建立产前诊断在医学领域引起了许多道德考虑和伦理困境。在管理选择中检测到严重的CA后果终止妊娠，使其成为无疑的伦理困境。方法利用印度尼西亚医学协会（Ikatan Dokter Indonesia）和皇家妇产科学院（RCOG）会议论文集等资源，对印度尼西亚与先天性异常相关的法律、伦理规范和法规进行文献检索。我们还利用PubMed、Clinical Key和Elsevier Science期刊的特定关键词进行了广泛的文献检索。结果产前诊断中经常出现伦理困境，这是一个复杂的过程，涉及五个不同的阶段：向父母披露信息，确定检查指征，提供诊断信息，提供心理和社会支持，做出诊断决定。Jonsen， Siegler和Winslade提出的框架可以应用于本案例中的伦理决策。结论因遗传异常或先天性残疾而选择终止妊娠必须符合法律依据。每个病人的自主原则和医生决定的结果都经过仔细考虑，产科医生必须尽一切努力尊重和保护人类生命的尊严。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Ethical dilemmas in voluntary termination of pregnancy with severe congenital anomalies

Background

Congenital anomalies (CA) are structural or functional disorders from genetic defects of the fetus occurring in the uterine. However, screening for congenital disabilities to establish a prenatal diagnosis raises many moral considerations and ethical dilemmas in the field of medicine. A detected severe CA consequence to termination of pregnancy in the management option, making it an undoubtful ethical dilemma.

Methods

A literature search was carried out on Indonesian laws, ethical codes, and regulations related to congenital anomalies, utilizing resources such as the Indonesian Medical Association (Ikatan Dokter Indonesia) and the conference proceedings of the Royal College of Obstetricians and Gynecologists (RCOG). An extensive literature search was also utilized from PubMed, Clinical Key, and Elsevier Science journals with specific keywords.

Results

Ethical dilemmas often arise in the context of prenatal diagnosis, which involves a complex process across five distinct stages: disclosure of information to parents, establishing indications for examinations, providing information about a diagnosis, providing psychological and social support, and making diagnostic decisions. The framework proposed by Jonsen, Siegler, and Winslade can be applied to ethical decision-making in the present case.

Conclusion

The choice to terminate a pregnancy due to genetic anomalies or congenital disabilities must comply with the legal bases. The principles of autonomy of each patient and the results of the doctor's decisions have been carefully considered, and the obstetrician must make every effort to respect and protect the dignity of human life.

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来源期刊

Ethics, Medicine and Public Health Medicine-Health Policy

CiteScore

2.20

自引率

0.00%

发文量

107

审稿时长

42 days

期刊介绍： This review aims to compare approaches to medical ethics and bioethics in two forms, Anglo-Saxon (Ethics, Medicine and Public Health) and French (Ethique, Médecine et Politiques Publiques). Thus, in their native languages, the authors will present research on the legitimacy of the practice and appreciation of the consequences of acts towards patients as compared to the limits acceptable by the community, as illustrated by the democratic debate.