The transition from innovation to standard of care for maternal-fetal surgery should be guided by ethical as well as scientific considerations. This chapter provides an ethical framework that identifies criteria for the investigation of maternal-fetal surgery. Using this framework, physicians should address the initiation and assessment of clinical trials to determine whether they establish a standard of care, use an appropriately informed consent process to recruit and enroll subjects, consider whether selection criteria should include the abortion preferences of the pregnant woman, and consider whether physicians have an obligation to offer referral to such investigation. This ethical framework, in a clinically comprehensive fashion, takes account of the physician's obligations to the fetal patient, the pregnant woman, and future fetal and pregnant patients. The ethical framework is illustrated by the example of fetal surgery for spina bifida.

译文

:从创新到孕产妇手术的护理标准的过渡应遵循道德和科学考虑。本章提供了一个道德框架,该框架确定了母婴手术研究的标准。使用该框架,医生应着手进行临床试验的开始和评估,以确定他们是否建立护理标准,使用适当的知情同意程序招募和招募受试者,考虑选择标准是否应包括孕妇的流产偏好,并考虑医生是否有义务转介此类调查。从临床上全面的角度来看,这种道德框架考虑了医生对胎儿患者,孕妇以及未来的胎儿和怀孕患者的义务。脊柱裂的胎儿手术实例说明了道德框架。

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