Ethics: "life before birth" and moral complexity in maternal-fetal surgery for spina bifida

This article considers the ethical significance of a moral belief common among pregnant women (and their partners) who seek open uterine repair for fetal spina, namely that their fetuses are already "babies." The need to recognize and interact sensitively with a pregnant woman's vulnerability to her own beliefs and concerns regarding potential disabilities, the fetal intervention, and its potential outcome is emphasized. Such recognition and explicit discussions are ethically important for informed consent and to safeguard against the judgments, enthusiasms, and biases of surgeons and other team members.