Contents -- Preface -- 1 The professional responsibility model of perinatal ethics -- 1.1 Introduction -- 1.2 Ethics, medical ethics, and perinatal ethics -- 1.2.1 Ethics -- 1.2.2 Medical ethics -- 1.2.3 Perinatal ethics -- 1.3 The professional responsibility model of perinatal ethics -- 1.3.1 Rights-based reductionism -- 1.3.2 The ethical concept of medicine as a profession -- 1.4 Conclusion -- 1.5 References -- 1.6 Summary points -- 2 Induced abortion and feticide -- 2.1 Introduction -- 2.2 Terminology -- 2.3 Offering induced during abortion or feticide -- 2.3.1 After viability -- 2.3.2 Before viability -- 2.4 Recommending induced abortion or feticide -- 2.5 Performing induced abortion or feticide -- 2.6 Referring for induced abortion or feticide -- 2.7 Conclusion -- 2.8 References -- 2.9 Summary points -- 3 Periviability -- 3.1 Introduction -- 3.2 Clinical outcomes data -- 3.3 Induced abortion -- 3.4 Obstetric and neonatal dimensions -- 3.5 Burdens on parents and society -- 3.6 Conclusion -- 3.7 References -- 3.8 Summary points -- 4 Intrapartum management -- 4.1 Introduction -- 4.2 A preventive ethics approach to cesarean delivery -- 4.3 Recommendations regarding mode of delivery -- 4.3.1 Recommending cesarean delivery -- 4.3.2 Offering both cesarean delivery and vaginal delivery -- 4.3.3 Recommending vaginal delivery -- 4.3.4 Responding to requests for non-indicated cesarean delivery -- 4.4 The role of destructive procedures -- 4.4.1 Cephalocentesis for intrapartum management of hydrocephalus -- 4.4.2 Isolated fetal hydrocephalus -- 4.4.3 Hydrocephalus with severe associated abnormalities -- 4.4.4 Hydrocephalus with other associated anomalies -- 4.5 Non-aggressive obstetric management -- 4.5.1 Aggressive and non-aggressive obstetric management defined.

4.5.2 When beneficence-based obligations to the fetal patient cease to exist -- 4.5.3 When beneficence-based obligations to the fetal patient become minimal -- 4.5.4 Counseling the pregnant woman in the informed consent process for non-aggressive obstetric management -- 4.6 Conclusion -- 4.7 References -- 4.8 Summary Points -- 5 Planned home birth -- 5.1 Introduction -- 5.2 Critical appraisal of the assumption that planned home birth is compatible with professional responsibility -- 5.3 Planned home birth attendants are not acting in a professional capacity -- 5.4 Professional responsibility and hospital birth -- 5.5 Respect for the pregnant women's rights -- 5.6 Professionally appropriate responses -- 5.6.1 What should perinatologists do to address the root cause of the recrudescence of planned home birth? -- 5.6.2 How should perinatologists respond when a woman raises the topic of planned home birth? -- 5.6.3 How should perinatologists respond to a woman's request for the perinatologist to participate in planned home birth? -- 5.6.4 How should perinatologists respond when a patient is received on emergency transport from a planned home birth? -- 5.6.5 Should obstetricians participate in or refer patients to a randomized controlled clinical trial of planned home vs. planned hospital birth? -- 5.7 Conclusion -- 5.8 References -- 5.9 Summary Points -- 6 Pregnant patients with mental disorders -- 6.1 Introduction -- 6.2 Clinical considerations -- 6.3 Responsibly managing the decision-making process -- 6.3.1 Chronically and variably impaired autonomy -- 6.3.2 Assisted decision making -- 6.3.3 Surrogate decision making -- 6.3.4 Strategies for dealing with strong feelings that these patients can evoke -- 6.4 Clinical applications.

6.4.1 The decision whether to continue a previable pregnancy to viability and thus to term -- 6.4.2 Intrapartum management -- 6.4.3 Decisions about child-rearing and adoption -- 6.5 Conclusion -- 6.6 References -- 6.7 Summary points -- 7 Neonatal management -- 7.1 Introduction -- 7.2 Neonatal medical ethics: Delivery makes a difference -- 7.3 Justified limits on resuscitation and neonatal critical care -- 7.4 The perinatologist's professional responsibility to reject infanticide: The Groningen Protocol is clinically unnecessary, unscientific, and unprofessional -- 7.4.1 Is The Groningen Protocol clinically necessary? -- 7.4.2 Is the Groningen Protocol scientific? -- 7.4.3 Is the Groningen Protocol professional? -- 7.5 Conclusion -- 7.6 References -- 7.7 Summary points -- 8 Perinatal innovation and research -- 8.1 Introduction -- 8.2 Innovation and research -- 8.3 Current research regulations -- 8.4 The central ethical challenge -- 8.5 Research designed to improve the health of pregnant women -- 8.6 Research designed to improve medical and surgical management of the fetal patient -- 8.7 Responsibly managing the transition from investigation to clinical practice -- 8.8 Conclusion -- 8.9 References -- 8.10 Summary points -- 9 Women and children first: Advocacy in perinatal medicine -- 9.1 Introduction -- 9.2 "Women and children first" -- 9.3 Justice-based professional responsibility -- 9.4 Challenges to justice in the allocation of healthcare resources to women and children -- 9.4.1 Challenges to substantive justice -- 9.4.2 Challenges to procedural justice -- 9.5 Conclusion -- 9.6 References -- 9.7 Summary points -- 10 Critically appraising the literature of perinatal ethics -- 10.1 Introduction -- 10.2 Four-step approach.

10.2.1 Step 1: Does the argument address a focused ethics question? -- 10.2.2 Step 2: Are the results of the argument valid? -- 10.2.3 Step 3: What are the results of the argument? -- 10.2.4 Step 4: How should I apply the results in clinical practice, research, or advocacy? -- 10.3 Conclusion -- 10.4 References -- 10.5 Summary points -- 11 Acknowledgements -- Index.