» Articles » PMID: 17400862

Risks, Values, and Decision Making Surrounding Pregnancy

Overview
Journal Obstet Gynecol
Date 2007 Apr 3
PMID 17400862
Citations 36
Authors
Affiliations
Soon will be listed here.
Abstract

Assessing, communicating, and managing risk are among the most challenging tasks in the practice of medicine and are particularly difficult in the context of pregnancy. We analyze common scenarios in medical decision making around pregnancy, from reproductive health policy and clinical care to research protections. We describe three tendencies in these scenarios: 1) to consider the probabilities of undesirable outcomes alone, in isolation from women's values and social contexts, as determinative of individual clinical decisions and health policy; 2) to regard any risk to the fetus, including incremental risks that would in other contexts be regarded as acceptable, as trumping considerations that may be substantially more important to the wellbeing of the pregnant woman; and 3) to focus on the risks associated with undertaking medical interventions during pregnancy to the exclusion of demonstrable risks to both woman and fetus of failing to intervene. These tendencies in the perception, communication, and management of risk can lead to care that is neither evidence-based nor patient-centered, often to the detriment of both women and infants.

Citing Articles

From the Front Lines: The Need for Stakeholder Coalitions in Preserving Reproductive Autonomy.

McGowan M, Allyse M, Condon N, Wheatley J, Pensak M Am J Bioeth. 2024; 24(2):46-48.

PMID: 38295260 PMC: 10985837. DOI: 10.1080/15265161.2023.2296405.


The ethics of consent during labour and birth: episiotomies.

van der Pijl M, Verhoeven C, Hollander M, de Jonge A, Kingma E J Med Ethics. 2023; 49(9):611-617.

PMID: 36717252 PMC: 10511989. DOI: 10.1136/jme-2022-108601.


Perception and Demands of Pregnant and Breastfeeding Women Regarding Their Role as Participants in Environmental Research Studies.

Company-Morales M, Zafra Aparici E, Casado L, Alarcon Montenegro C, Arrebola J Int J Environ Res Public Health. 2021; 18(8).

PMID: 33919934 PMC: 8070940. DOI: 10.3390/ijerph18084149.


I felt so much conflict instead of joy: an analysis of open-ended comments from people in British Columbia who declined care recommendations during pregnancy and childbirth.

Stoll K, Wang J, Niles P, Wells L, Vedam S Reprod Health. 2021; 18(1):79.

PMID: 33858469 PMC: 8048186. DOI: 10.1186/s12978-021-01134-7.


Opinion: It's ethical to test promising coronavirus vaccines against less-promising ones.

Eyal N, Lipsitch M Proc Natl Acad Sci U S A. 2020; 117(32):18898-18901.

PMID: 32699147 PMC: 7431044. DOI: 10.1073/pnas.2014154117.