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Publicly Available Published by De Gruyter May 17, 2012

Ethical challenges in the management of multiple pregnancies: the professional responsibility model of perinatal ethics

  • Frank A. Chervenak EMAIL logo and Laurence B. McCullough


Ethics is an essential component for the responsible clinical management of multiple gestation and decision-making about such pregnancies with pregnant women. The ethical concept of the fetus as a patient is presented as the basis for identifying a professionally responsible approach to selective termination, twin-to-twin transfusion syndrome, and to discordant beneficence-based obligations that exist when one or more fetuses are adversely affected by a fetal anomaly or complication of pregnancy. The roles for directive counseling, i.e., making evidence-based recommendations, and for non-directive counseling, i.e., offering evidence-based alternatives but making no recommendations, are described. The professional responsibility model of perinatal ethics creates a practical framework to guide the clinical judgment of perinatologists and the informed process about the clinical management of multiple pregnancies.

Corresponding author: Frank A. Chervenak, MD New York Presbyterian Hospital 525 East 68th Street M-724, Box 122 New York NY 10065 USA 212.746.3012 212.746.8727

Received: 2012-3-20
Accepted: 2012-3-20
Published Online: 2012-05-17
Published in Print: 2013-01-01

©2012 by Walter de Gruyter Berlin Boston

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