The Fetus as a Patient

Due to new developments in prenatal testing and therapy the fetus is increasingly visible, examinable and treatable in prenatal care. Accordingly, physicians tend to perceive the fetus as a patient and understand themselves as having certain professional duties towards it. However, it is far from clear what it means to speak of a patient in this connection.
This volume explores the usefulness and limitations of the concept of 'fetal patient' against the background of the recent seminal developments in prenatal or fetal medicine. It does so from an interdisciplinary and international perspective. Featuring internationally recognized experts in the field, the book discusses the normative implications of the concept of 'fetal patient' from a philosophical-theoretical as well as from a legal perspective. This includes its implications for the autonomy of the pregnant woman as well as its consequences for physician-patient-interactions in prenatal medicine.

Dagmar Schmitz is Assistant Professor of Medical Ethics and Theory at the Institute for History, Theory and Ethics in Medicine, RWTH Aachen University, Germany, and a member of the German Commission on Genetic Testing (GEKO). In her research, she is especially interested in ethical aspects of physician-patient-interactions and the beginning of life. Angus Clarke is Clinical Professor at the Institute of Cancer and Genetics, Cardiff University, UK. He works as a clinical geneticist and teaches students of medicine and of genetic counselling. He undertakes research on the social and ethical aspects of human genetics and contributes to policy discussions on genetic services within UK and Europe. Wybo Dondorp is Associate Professor of Biomedical Ethics, Research Schools CAPHRI and GROW, at Maastricht University, the Netherlands. His research interests include the ethics of reproductive medicine, genomics, and population screening. He is a member of the Health Council of the Netherlands and past coordinator of the Special Interest Group on Ethics of the International Society of Prenatal Diagnosis and Fetal Therapy (ISPD).

Part I: Introduction; 1.The Fetus as a Patient - a Sustainable Approach for Clinical Interactions in the Field of New Prenatal Medicine?; Part II: The Fetus as a Patient: A useful concept?; 2. The Disposable and Protected Fetus: Contradictions in Fetal Status; 3. Which Ethics for the Fetus as a Patient?; 4.The Ethical Concept of the Fetus as a Patient: Responses to its Critics; 5.Treating the Fetus as a Patient: Possible Implications for its Moral Status; Part III: The Fetus as a Patient: Where does that leave the pregnant woman?; 6. Insights from a Perspective of Cultural Anthropology: A Discourse Analysis of Representations of (Genetic) Reproductive Medicine and the Fetus in Popular Media; 7.The Fetus as a Patient in Professional and Patient Discourses; 8. Means, Ends and the Fetal Patient; 9. Caring for Pregnant Cancer Patients; Part IV: The Fetus as a Patient: Challenges for clinical care pathways and interactions; 10. Treatments and Trials for the Fetal Patient: Imposing the Burdens of Enthusiasm?; 11. Ethics of Involving Pregnant Women in Fetal Therapy Trials; 12. The 'Normalization' of Prenatal Screening: Prevention as Prenatal Beneficence?; 13. Beyond the Fetal Patient: The Ethics of Fetal Treatment for Down Syndrome; 14. Prenatal Therapy for Differences of Sexual Development (DSD): Fuzzy Boundaries in the Clinical Discussion and the Ethical Debate; 15. Perinatal Palliative Care as an Option in Prenatally Diagnosed Severe, Life-Limiting Conditions of the Fetus; Part V: The Fetus as a Patient: Legal perspective; 16. The Legal Status of the Fetus as a Patient in Europe