The practice of medicine is a moral enterprise involving values that may conflict. Autonomy, beneficence / nonmaleficence, justice, veracity and fidelity are well defined and supported ethical values in medicine.
It is important to consider these values both from the patient’s / family’s perspective and the healthcare professional’s perspective. The ongoing relationship between the healthcare professional and the patient / family forms the foundation on which decisions are made.
These values may provide clarity and guidance when there is a difference of opinion. We define these terms below.
Refers to a person’s right to make choices regarding oneself. A pregnant woman is in a unique position in that she is/represents, in effect, two patients, herself and her fetus (or her children in the case of a multiple pregnancy). An autonomous informed decision made by a pregnant woman will affect both patients. Autonomy also refers to the self-governance of the healthcare professional, in so far as the healthcare professional comes to the relationship with a set of moral standards by which to live.
They entail acting to benefit a person and to avoid harm. These principles require trust in the patient / healthcare provider relationship such that appropriate recommendations will be made to honor these values. Treatments that result in short-term harm may be recommended and tolerated for long-term benefit.
Though defined multiple ways, is most frequently understood in the healthcare context as allocation of healthcare according to need, regardless of the ability to pay. It is not allocation according to contribution, effort or entitlement.
Or truth telling, is the hallmark of a fiduciary relationship. In order to provide quality healthcare, the healthcare professional requires accurate information pertinent to the problem from the patient or family. In addition, the patient or family needs accurate information about the diagnosis, prognosis, and treatment options to make an informed decision.
The obligation to act in good faith to keep vows and promises, to honor ethical principles, to fulfill agreements, to maintain relationships and fiduciary responsibilities.
In addition to the ethical values discussed above, the ethical integrity of the healthcare professional is vital to the delivery of quality healthcare. It involves a moral attitude and sensitivity to other people’s needs, whether patients, families, colleagues, and includes such virtues as compassion, empathy, honesty, humility and courage. Courage, in this context, implies that a healthcare professional maintains his or her moral stance.
The Fetal Care Center is committed to quality medical care that is safe and based on the best medical knowledge available. When a therapeutic innovative procedure is offered to a patient there should be a compelling rationale and a high likelihood of success even when a clear prediction of outcome cannot be made. (Beneficence / Nonmaleficence)
The Fetal Care Center is committed to quality clinical research. When patients and families are referred to the Fetal Care Center they should be apprised of the research nature and identity of the program. All clinical research is governed by the ethical principles set forth on this page.
The Cincinnati Children's Fetal Care Center clinical director, Fetal Care Center medical director annual review.
Last revised Aug. 11, 2010