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ETHICS IN MEDICINE   University of Washington School of Medicine

Maternal-Fetal Conflict:
Case 2

A 22-year-old woman in her first pregnancy with an unremarkable prenatal course presents with preterm labor at 28 weeks gestation. Her contractions were successfully stopped with terbutaline. Discharge planning was reviewed with her, and she was instructed to follow a regimen of bedrest and oral terbutaline. She reported that she did not intend to comply with these instructions. She believed that God would not allow her to labor unless it was time for the baby to deliver, and she indicated that He had communicated this to her.

How can the physician ensure nonmaleficence towards the mother and still promote beneficence towards her fetus? Is the mother competent? Should maternal autonomy prevail over other ethical concerns?

Discussion

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