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Paternalism

December 20, 2016

Lisa Morgan arrives in the office of Dr. Karen Anderson, her obstetrician/gynecologist. Dr. Anderson, who is going over her schedule for the day, hopes that Lisa is not pregnant again. Less than 2 years ago, Dr. Anderson had performed a therapeutic abortion for Lisa, who is now 20 years old and unmarried. The doctor’s concerns … Continued

Shame, Gender, Birth

December 20, 2016

In recent years, critics of modern obstetrics have cited technology as responsible for women’s discontent regarding childbirth. In this essay, I investigate and pry apart the connection between the quality of childbirth experience and technology. After identifying three factors considered constitutive of a ‘good birth,’ I demonstrate how technology can either facilitate or hinder each, … Continued

Untying the Gordian Knot

December 20, 2016

Since the first successful transplantation of umbilical cord blood in 1988, cord blood has become an important source of hematopoietic stem and progenitor cells for the treatment of blood and genetic disorders. Significant progress has been accompanied by challenges for scientists, ethicists, and health policy makers. With the recent recognition of the need for a … Continued

The Social Implications of Embryo Cryopreservation

December 20, 2016

OBJECTIVE: To summarize the existing literature regarding the social implications of embryo cryopreservation and outline areas in need of further study. RESULT(S): The potential social impact of oocyte cryopreservation has not been investigated. Embryo cryopreservation has been increasingly used to improve the cost-effectiveness of in vitro fertilization (IVF) and expand the options available to infertile … Continued

Maternal-Fetal Surgery for Treatment of Myelomeningocele

December 20, 2016

Maternal-fetal surgery for repair of fetal MMC is experimental treatment for which ethically justified clinical trials are not yet possible because equipoise is not established on medical or nonmedical grounds. We have focused here on only two of the important questions raised by this surgery. At least three others might have been considered. First is … Continued

Attitudes of Maternal-Fetal Specialists Concerning Maternal-Fetal Surgery

December 20, 2016

OBJECTIVE: We examined the attitudes of members of the Society for Maternal-Fetal Medicine regarding the clinical, scientific, ethical, and policy issues in maternal-fetal surgery. STUDY DESIGN: A 43-question survey was distributed to all members of the Society for Maternal-Fetal Medicine. Two mailings and one electronic mail reminder were sent, each with instructions to submit the … Continued

Toward the Ethical Evaluation and Use of Maternal-Fetal Surgery

December 20, 2016

BACKGROUND: Important clinical, social, and ethical questions are associated with the evaluation and use of surgical approaches aimed at correcting fetal anatomic abnormalities. In particular, the expansion of maternal-fetal surgery to ameliorate nonlethal fetal conditions has intensified the need to address issues about the adequacy of technology assessment and the safety of those who undergo … Continued

Human Immunodeficiency Virus and Assisted Reproduction

December 20, 2016

OBJECTIVE: To review the advances in the treatment of human immunodeficiency virus (HIV) infection and revisit the medical, ethical, and legal issues surrounding infertility management in HIV-infected couples. DESIGN: Analytic review. RESULTS(S): HIV infection continues to be a serious public health and reproductive issue. However, present policies which allow for the categorical exclusion of HIV-infected … Continued