Fetal therapy - Ethical considerations

Decisions to undertake fetal therapy involve a complex assessment of the be st interests of the fetus and a pregnant woman's interest in her own health and freedom from unwanted invasion of her body. Pregnant women almost alwa ys accept a recommendation for fetal therapy that is approached collaborati vely, especially if the therapy is of proven efficacy and has a low materna l risk. Fetal therapy of unproven efficacy should only be undertaken as par t of an approved research protocol. In recommending fetal therapy of proven efficacy, physicians should respect maternal choice and assessment of risk . Under limited circumstances when fetal therapy would be effective in prev enting irrevocable and substantial fetal harm with negligible risk to the h ealth and well-being of the pregnant woman, should the pregnant woman be op posed to the intervention, physicians should engage in a process of communi cation and conflict resolution that may require consultation from an ethics committee and, in rare cases, require judicial review. A physician should never intervene without the woman's explicit consent before judicial review .