Reproductive ethics in clinical practice : preventing, initiating, and managing pregnancy and delivery : essays inspired by the MacLean Center for Clinical Medical Ethics lecture series

Reproductive health care professionals in fields such as Obstetrics and Gynecology, Family Medicine, and Pediatrics face difficult ethical issues because they work at the crossroads of patient decision-making, scientific advancement, political controversy, legal regulation, and profound moral considerations. The dilemmas these professionals face expose big-picture bioethics questions of interest to everyone. Yet for clinicians striving to deliver excellent patient care, the ethical questions that make daily practice challenging can be just as nuanced. This volume presents a carefully curated compilation of essays written by leading experts in the fields of medicine, ethics, and law, who address key issues at the forefront of reproductive ethics. It is organized into three main sections: I. Contraception and Abortion Ethics - Preventing Pregnancy and Birth, II. Assisted Reproduction Ethics - Initiating Pregnancy, and III. Obstetric Ethics - Managing Pregnancy and Delivery. Each section begins with a short introduction by the editors providing an overview of the area and contextualizing the essays that follow. This volume's primary aim is to be useful to practicing clinicians, students, and trainees by providing short and practical essays covering urgent topics--from race, religion and abortion, to legal liability, violations of confidentiality and maternal choices that risk future children's health. This collection provides clinicians at all levels of training with frameworks they need to approach the intimate and high-stakes encounters central to their profession. COVER 1 Reproductive Ethics in Clinical Practice Preventing, Initiating, and Managing Pregnancy and Delivery 4 Copyright 5 Dedication 6 Contents 8 Acknowledgments 12 About the Authors 14 Introduction 24 SECTION I 8 Overview: Contraception and Abortion Ethics 32 1. Why Reproductive Justice Matters to Reproductive Ethics 40 2. Religiously Affiliated Healthcare Institutions: An Ethical Analysis of What They Mean for Patients, Clinicians, and Our Health System 52 3. Contemporary Challenges to Providing Confidential Reproductive Healthcare to Minors 67 4. Contraception and Abortion in the United States: A Brief Legal History 85 SECTION II 100 Overview: Assisted Reproduction Ethics 102 5. The Reproduction of Stratified (Assisted) Reproduction: Epidemiology, History, and Ideology in Infertility Care 107 6. Preimplantation Genetics: Liabilities and Limitations 121 7. Who Are Your Patients, and What Happens When They Disagree? Conflicts in Treating Multiple Parties Engaging in Third-​Party Reproduction 133 8. Ethical Issues in Oocyte Donation 146 9. Oncofertility: Ethics and Hope after Cancer 159 10. Accessing Reproductive Technology in France: Strengths and Limits of a Model that Privileges “Just Reproduction” above Respect for Autonomy 174 SECTION III 186 Overview: Obstetric Ethics 188 11. Refusing to Force Treatment: Reconciling the Law and Ethics of Post-​Viability Treatment Refusals and Post-​Viability Abortion Prohibitions 193 12. Professional Ethics in Obstetric Practice, Innovation, and Research 220 13. Doing Harm: When Healthcare Providers Report Their Pregnant Patients to the Police and Other Authorities 235 14. Prenatal Counseling for Maternal–​Fetal Surgery: Potential Biases, Competing Interests, and Undue Practice Variation in the World of Fetal Care 255 15. Ethical Issues in Academic Global Reproductive Health 270 "Like all clinicians, reproductive health care providers face specialty-specific ethical questions. However, the first editor of this book, Dr. Julie Chor (JC), has never found an ethics text that is tailored to the needs of practicing clinicians, students, and trainees in Reproductive Healthcare. This is an unfortunate gap in the literature, because whether reproductive health providers come from Obstetrics and Gynecology, Family Medicine, Pediatrics or another field, they all must be able to identify and analyze complex ethical issues that lie at the crossroads of patient decision-making, scientific advancement, political controversy, government regulation, and profound moral considerations in the context of continually evolving medical, legal, and societal factors. To fill this gap, Dr. Chor invited co-editor Professor Katie Watson (KW) to partner in creating the text that she has always longed to use but has never found as an Obstetrician-Gynecologist practicing and teaching in this complex milieu"-- Provided by publisher