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Ethical challenges of decision making with pregnant patients who have schizophrenia.

Abstract：

OBJECTIVE:Because there is a dearth of literature, we developed an ethical framework to guide decision making about the management of pregnancy of patients with schizophrenia. STUDY DESIGN:We review pertinent literature on schizophrenia and pregnancy, including information on maternal and fetal risks and outcomes, and relate this information to ethical concepts. RESULTS:The ethical framework has five components: the concept of chronically and variably impaired autonomy, assisted decision making, surrogate decision making, strategies for dealing with the physician's feelings in response to these patients, and the concept of the fetus as a patient. We apply this ethical framework to clinical challenges of decision making during pregnancy with this patient population. CONCLUSIONS:The preventive ethics strategies of assisted and surrogate decision making can be used to prevent ethical conflicts in decision making about the management of pregnancy of patients with schizophrenia. These preventive ethics strategies should contribute significantly to reducing the vulnerability of these patients and therefore to enhancing their autonomy in the physician-patient relationship.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

McCullough LB,Coverdale JH,Chervenak FA

doi

10.1067/mob.2002.125767

subject

Has Abstract

pub_date

2002-09-01 00:00:00

pages

696-702

issue

3

eissn

0002-9378

issn

1097-6868

pii

S0002937802001904

journal_volume

187

pub_type

杂志文章

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