Ethics of Fetal Surgery

Surgeons sometimes operate on the developing fetuses in utero of pregnant women to treat a number of congential abnormalities, operations that have ethical aspects. A. William Liley performed the first successful fetal surgery, a blood transfusion, in New Zealand in 1963 to counteract the effects of hemolytic anemia [6], or Rh disease, on a fetus [7]. The ethical discussions surrounding fetal surgery are complex and are still being defined, as fetal surgery represents an emerging field of in utero medical interventions that impact the quality of life for both pregnant women and fetuses. Such discussions involve the ethical relationships between parents, fetuses, doctors, and health care organizations like hospitals. What may benefit the fetus [7] may harm the pregnant woman, and what may benefit the pregnant woman could negatively impact the viability [8] of the pregnancy [9]. Risks to the pregnant woman include preterm membrane rupture, preterm labor, wound infection, hemorrhage, loss of uterus [10], damage to the organs near the uterus [10], and possibly death. Fetal surgery does not always improve the quality of life for the developing fetus [7], and the risks and benefits of fetal surgery must be weighed and discussed between the medical team, the pregnant woman, and her partner to customize the most ethical plan of action.