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Parental request for non-resuscitation in fetal myelomeningocele repair: an analysis of the novel ethical tensions in fetal intervention

Journal of Perinatology volume 42, pages 856–859 (2022)Cite this article

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Abstract

As the field of fetal intervention grows, novel ethical tensions will arise. We present a case of Fetal myelomeningocele repair involving a 25-week fetus where parents requested that if emergent delivery was necessary during the open uterine procedure, that the medical team did not perform resuscitation. This question brings forward an important discussion around the complicated space of maternal autonomy, child rights, and clinician obligations that exists in fetal intervention. In some regions, a mother in this situation may choose to terminate the pregnancy. Parents could also choose not to do the surgery. Parents in some regions could opt for no resuscitation of a child born at 25-weeks’ gestation. We offer an analysis of these relevant considerations, the different tensions, and the conflicting duties between the mother, fetus, and medical team. This analysis will provide ethical and clinical guidance for future questions that may arise in this burgeoning field.

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No funding was received for this paper.

Author information

Authors and Affiliations

  1. Children’s Minnesota, Clinical Ethics Department, Minneapolis, MN, USA

    Ian D. Wolfe

  2. Children’s Minnesota, Midwest Fetal Care Center, Minneapolis, MN, USA

    Joseph B. Lillegard

  3. Pediatric Surgical Associates, Minneapolis, MN, USA

    Joseph B. Lillegard

  4. Children’s Mercy Bioethics Center, Kansas City, MO, USA

    Brian S. Carter

  5. Departments of Pediatrics (Neonatology), and Medical Humanities & Bioethics, University of Missouri-Kansas City, Kansas City, MO, USA

    Brian S. Carter

Authors
  1. Ian D. Wolfe
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  3. Brian S. Carter
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Contributions

IDW conceptualized and drafted the initial paper. JBL and BSC contributed to the drafting, design, and content of the paper. All authors contributed to review and revision of the paper and approve the final version.

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Correspondence to Ian D. Wolfe.

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The authors declare no competing interests.

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Wolfe, I.D., Lillegard, J.B. & Carter, B.S. Parental request for non-resuscitation in fetal myelomeningocele repair: an analysis of the novel ethical tensions in fetal intervention. J Perinatol 42, 856–859 (2022). https://doi.org/10.1038/s41372-022-01317-5

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