Reproductive Ethics in Clinical Practice: Preventing, Initiating, and Managing Pregnancy and Delivery--Essays Inspired by the MacLean Center for Clinical Medical Ethics Lecture Series

by Julie Chor (Editor), Katie Watson (Editor)

Overview

Reproductive health care professionals in fields such as Obstetrics and Gynecology, Family Medicine, and Pediatrics face difficult ethical issues because they work at the crossroads of patient decision-making, scientific advancement, political controversy, legal regulation, and profound moral considerations. The dilemmas these professionals face expose big-picture bioethics questions of interest to everyone. Yet for clinicians striving to deliver excellent patient care, the ethical questions that make daily practice challenging can be just as nuanced.

This volume presents a carefully curated compilation of essays written by leading experts in the fields of medicine, ethics, and law, who address key issues at the forefront of reproductive ethics. It is organized into three main sections: I. Contraception and Abortion Ethics - Preventing Pregnancy and Birth, II. Assisted Reproduction Ethics - Initiating Pregnancy, and III. Obstetric Ethics - Managing Pregnancy and Delivery. Each section begins with a short introduction by the editors providing an overview of the area and contextualizing the essays that follow. This volume's primary aim is to be useful to practicing clinicians, students, and trainees by providing short and practical essays covering urgent topics—from race, religion and abortion, to legal liability, violations of confidentiality and maternal choices that risk future children's health. This collection provides clinicians at all levels of training with frameworks they need to approach the intimate and high-stakes encounters central to their profession.

Product Details

ISBN-13:	9780190873011
Publisher:	Oxford University Press
Publication date:	07/20/2021
Pages:	284
Sales rank:	987,679
Product dimensions:	9.20(w) x 6.20(h) x 0.70(d)

About the Author

Julie Chor, MD, MPH is an Assistant Professor of Obstetrics and Gynecology and an Assistant Director of the MacLean Center for Clinical Medical Ethics at the University of Chicago. After completing medical school at the University of Chicago's Pritzker School of Medicine, Dr. Chor completed her Obstetrics and Gynecology residency, Fellowship in Family Planning, and MPH at the University of Illinois at Chicago. Her academic and clinical work focus on understanding and addressing barriers that adolescents and young adults face in seeking and obtaining reproductive health care. Dr. Chor also serves as a member of the American College of Obstetricians and Gynecologists' Committee on Ethics.

Katie Watson, JD is Associate Professor of Medical Social Sciences, Medical Education, and Obstetrics & Gynecology, and a Core Faculty Member of the Medical Humanities and Bioethics Graduate Program at Northwestern University's Feinberg School of Medicine. She clerked in the federal judiciary and worked in public interest law before completing Fellowships in Clinical Medical Ethics at the MacLean Center at the University of Chicago, and in Medical Humanities at NU-FSM. Her work focuses on women's health and reproductive ethics, and she is the author of Scarlet A: The Ethics, Law, and Politics of Ordinary Abortion (OUP, 2018). She is currently a Board member and Chair of the Ethics Committee of the National Abortion Federation, a Member of and the Bioethics Advisor to the National Medical Council of Planned Parenthood Federation of America, a member of the Editorial Board of the AMA Journal of Ethics, and a former Board member of the American Society for Bioethics and Humanities.

Table of Contents

Chapter 1. Introduction: Julie Chor, MD, MPH and Katie Watson, JD

I. Family Planning and Abortion: Preventing Pregnancy and Birth
Chapter 2. Orienting Essay: Julie Chor, MD, MPH and Katie Watson, JD
Chapter 3. Why Reproductive Justice Matters to Reproductive Ethics, Melissa Gilliam MD MPH and Dorothy Roberts JD
Chapter 4. Religiously Affiliated Healthcare Institutions: An Ethical Analysis of What They Mean for Patients, Clinicians, and Our Health System, Lori Freedman PhD and Debra Stulberg MD, MA
Chapter 5. Contemporary Challenges to Providing Confidential Reproductive Health Care to Minors, Amber Truehart, MD, MSc, Lee Hasselbacher, JD, Julie Chor, MD, MPH
Chapter 6. Legal History of Contraception and Abortion in the United States, David Strauss JD,

II. Assisted Reproduction: Getting Pregnant
Chapter 7. Orienting Essay: Julie Chor, MD, MPH and Katie Watson, JD
Chapter 8. Ethics and Stratified (Assisted) Reproduction, Lisa Harris MD PhD
Chapter 9. Preimplantation Genetics: Liabilities and Limitations, Valerie Koch JD
Chapter 10. Who are Your Patients, and What Happens when They Disagree? Conflicts in Treating Multiple Parties Engaging In Third Party Reproduction, Heather Ross JD
Chapter 11. Controversial Issues Surrounding Oocyte Donation, Susan Klock PhD
Chapter 12. Onco-Fertility: Ethics and Hope After Cancer, Bruno Ramalho de Carvalho, MD, MSc, MBA, Jhenifer Kliemchen Rodrigues, BSc, MSc, PhD, and Teresa K. Woodruff, MD, PhD.
Chapter 13. Accessing Reproductive Technology in France: Strengths and Limits of a model that privileges "Just reproduction" above Respect for autonomy, Laurence Brunet et Véronique Fournier

III. Obstetric Ethics: Managing Pregnancy and Delivery
Chapter 14. Orienting Essay: Julie Chor, MD, MPH and Katie Watson, JD
Chapter 15. The fallacy of forced treatment: Reconciling the law and ethics of post-viability treatment refusals & post-viability abortion prohibitions, Katie Watson, JD
Chapter 16. Professional Ethics in Obstetrics Practice and Research, Frank A. Chervenak, MD and Laurence McCullough PhD
Chapter 17. Doing Harm: When Health Care Providers Report their Pregnant Patients to the Police and Other Authorities, Jeanne Flavin, PhD and Lynn M. Paltrow, J.D
Chapter 18. Prenatal counseling for maternal-fetal surgery: Potential biases, competing interests, and undue practice variation in the world of Fetal Care, Stephen D. Brown, MD
Chapter 19. Ethical Issues in Academic Global Reproductive Health, Kayte Spector-Bagdady JD MBE and Timothy R. B. Johnson MD

Editorial Reviews

Reviewer: Patricia C Santiago-Munoz, MD (University of Texas Southwestern Medical Center)
Description: This book is a very well-researched and carefully curated collection of essays on reproductive ethics, meant for practicing clinicians. It is divided into three main sections, each section dealing with the ethics surrounding contraception and abortion, the ethics of assisted reproduction technologies, and ethical issues that might arise in the care of the pregnant patient.
Purpose: The editors and contributing authors set out to put together an ethics book specific to the field of obstetrics that they had sought during their years of training but had never found — one that addresses the "needs of practicing clinicians, students, and trainees in reproductive health care." As a specialist in maternal fetal medicine, I had not encountered an ethics tome specific to obstetrics. The topics addressed in this book are incredibly sensitive, and the subject of much controversy. They are addressed with reason, factual information, and great attention to presenting clinical scenarios one is likely to encounter in practice. The book meets its objectives and opens the door to continue exploring each topic in more depth with the extensive references provided.
Audience: The book is intended for trainees (students, residents, fellows) and providers (physicians, advanced practice practitioners, nurses) in the field of obstetrics. I would add that it is also intended for those interested in the laws surrounding issues of reproductive justice. The book meets the needs of its audience and I look forward to making this book required reading for our trainees, particularly those in OB-GYN residency and those seeking to become subspecialty providers in reproductive health. The editors and contributors are all experts in their fields, whether obstetrics, law, philosophy, or medical ethics. Drs. Chervenak and McCullough, for example, are well known in the world of maternal fetal medicine as experts in obstetrical ethics.
Features: One aspect of the book that is particularly refreshing is the credibility of the clinical scenarios, probably because so many of the contributors are actual practicing physicians and they are not describing situations in the abstract or situations that they have never been a part of. The language throughout the book is easily accessible to anyone with a basic knowledge of the four guiding principles of ethics — autonomy, beneficence, non-maleficence, justice — and even then, the authors do a stellar job of reviewing these ethical concepts and presenting more complex ones (i.e., legal status vs. moral status of fetuses) with clear and granular examples. Some chapters, for example, those dealing with abortion, lay out the history of abortion in the U.S. and present the legal framework on which reproductive justice may be built or argued. The authors also provide examples taken from case law to highlight precedent and relate it to our duties to patients. I look forward to re-reading many of the chapters and reviewing the original documents referred to in the text.
Assessment: This book should be a starting point to any discussion with trainees regarding the provision of ethical care to pregnant patients. I found the subject matter humbling as a practicing physician, a reminder of our duties as doctors and how we may have, on occasion, failed to act in the best interest of our patients. It was a much-needed review of ethics and a well-argued re-framing of these concepts within the world of obstetrics. I have not encountered similar books in the past. Though the AMA Code of Medical Ethics and similar guidance from professional societies exists to direct conversations in difficult clinical situations, this book puts all of these clinical scenarios in one place and forces us to examine our conscience so that we may dare to challenge questionable or unethical laws we may be faced with.

Doody's Review Service

"Reproductive ethics in clinical practice is a timely and important resource. Masterfully curated by Julie Chor (an obstetrician-gynecologist) and Katie Watson (a bioethics professor and lawyer), the book deftly integrates scholarly depth with actionable guidance for practicing clinicians." — Anne Drapkin Lyerly, Departments of Social Medicine and Obstetrics and Gynecology, Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Bioethics

"a very well-researched and carefully curated collection of essays ... a much-needed review of ethics and a well-argued re-framing of these concepts within the world of obstetrics" — Patricia C. Santiago-Munoz, Doody's

"This important, timely collection of 15 essays is organized into three sections covering, respectively, contraception and abortion, assisted reproduction, and pregnancy and delivery." — E. R. Paterson, CHOICE

From the Publisher