Informed consent, bioethical equipoise, and hypoplastic left heart syndrome.

Abstract:

:In utero diagnosis of complex progressive cardiac disease such as hypoplastic left heart syndrome presents a novel opportunity for antepartum, intrapartum, and neonatal management. The clinical possibilities and potential for differing outcomes challenge the mother-foetus dyad with regard to informed consent. Previous studies reveal that rates of termination of pregnancy for foetuses with hypoplastic left heart syndrome vary widely in the United States and Europe, leading us to surmise that informed consent may be practised differently. The purpose of this paper is to review the ethical considerations and physician responsibilities of informed consent as they relate to prenatal and postnatal patients with hypoplastic left heart syndrome. Special consideration is paid to the informed consent process as practised by the obstetrician, perinatologist, paediatric cardiologist, and paediatric cardiac surgeon as it relates to termination of pregnancy, comfort care, and surgical palliation. We will argue that informed consent as it relates to hypoplastic left heart syndrome is far from standardised and that there exists a state of bioethical equipoise concerning the extent and limits of its application in the current clinical setting.

journal_name

Cardiol Young

journal_title

Cardiology in the young

authors

Mavroudis C,Mavroudis CD,Farrell RM,Jacobs ML,Jacobs JP,Kodish ED

doi

10.1017/S1047951111001715

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

133-40

eissn

1047-9511

issn

1467-1107

pii

S1047951111001715

journal_volume

21 Suppl 2

pub_type

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