Ethical and legal approaches to 'the fetal patient'

The concept of fetuses being 'patients' can serve a benign protective, cautionary purpose, alerting healthcare providers and pregnant women to the implications that medical treatment can have for fetuses. The concept allows women to provide the children they intend to deliver with the care they consider appropriate. A negative effect occurs, however, if healthcare providers decide to treat pregnant women according to providers' own views of the best interests of fetuses, and compromise patients' care and self-determination without their informed consent. Some activists advocate rights of fetuses for the purpose of limiting pregnant women's self-determination. Recognition that fetuses have legitimate interests, rather than rights, is common, and opens a way to balancing various competing interests without compromising patients' rights to decide on their medical care. Courts of law generally favor this approach, and tend to allow few limits on women's choice of indicated medical care while pregnant. (C) 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.