Maternal Brain Death During Pregnancy: Medical and Ethical Issues
Field, David R.
Gates, Elena A.
Creasy, Robert K.
Jonsen, Albert R.
Laros, Russell K.
JAMA. 1988 Aug 12; 260(6): 816-822.
Physicians and an ethicist at the University of California, San Francisco, present the details of the case of a pregnant, brain-dead woman whose vital functions were maintained for nine weeks until the delivery of a healthy infant at 31 weeks' gestation. Despite the technical difficulties involved and the economic costs incurred ($183,031 for maternal care and $34,703 for neonatal care), the authors conclude that ethical considerations support the decision on care. They argue that the woman was not injured; that nonmaleficence and beneficence toward the fetus require a rescue attempt if there is a reasonable chance of reaching fetal maturity; that maternal medical care may be more cost effective than prolonged neonatal support; and that the father's wishes were respected. Rather than proposing guidelines, they hold that decisions on prolonged maternal support should be based on the circumstances of each case. (KIE abstract)
Allowing to Die; Beneficence; Biomedical Technologies; Brain; Brain Death; Case Studies; Cesarean Section; Costs and Benefits; Consent; Death; Decision Making; Determination of Death; Economics; Fathers; Fetuses; Guidelines; Life; Moral Obligations; Newborns; Nonmaleficence; Parental Consent; Patient Care; Physicians; Pregnant Women; Prognosis; Prolongation of Life; Pregnancy; Resource Allocation; Rights; Risks and Benefits; Viability;
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