Cause and Effect of Content of Information

A 26-year-old, 28 weeks pregnant woman underwent ultrasound examinations. The physician who performed the final examination informed the woman that the fetus had a lethal brain malformation. Birth was then induced prematurely not only in accordance with the mother’s wishes, but also because it was considered to give the child a better prognosis. After birth, the child’s condition improved much more positively than anticipated. The woman, however, strongly expressed that she wanted treatment to be withheld. The physician thought this was unethical. He felt he had a duty to save the life of the child. All the people involved experienced great difficulty in communicating with the mother.

• Could the absolute and pessimistic content of information given to the woman before birth have induced or strengthened her feeling of hopelessness and rejection of the baby?
• If the ultrasound findings had been presented with reservation reflecting the uncertainty which always is associated with this kind of information, would the mother might more easily have accepted treatment of her child?
• Because the prognosis of the child seemed to be so good, would it have been wrong not to treat the child actively?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

J Med Ethics 2005;31:73–77. doi: 10.1136/jme.2003.003954