Who owes what to whom in the context of Maternal-Fetal Therapy?

The 2009’s CEG’s monitoring report Care for the unborn child is a very inclusive overview of the main ethical, societal, political, and juridical issues posed by the possibility of intervening upon pregnant women for the sake of the clinical interests of their fetuses or of the children that they might become.

Without trying to be exhaustive and in no particular order, the report found the definition of the moral status of the fetus, including the relatively new concept of ‘fetal patienthood’, the meaning and content of the moral obligations of pregnant women, physicians, and researchers towards that ‘patient’, and the moral acceptability of abortion, amongst the most morally challenging aspects of ‘fetal therapy’.

Although some of the positions taken there are in my opinion ill developed, such as the idea that we owe something now to future children, one must admit that the report is thought provocative in the most radical and positive sense of these words. And you can see that from the start!

Unlike many other CEG publications, a stance in the dispute about the moral and legal status of the fetus seems to be taken already in the title. The expression ‘care for the unborn child’ ascribes in fact a certain status with a certain moral and legal connotation to the fetus that many of us believe it does not already possess (that of being a child).

Despite all objections we may have, the report is as important today as it was when it was published in 2009, a time when the results of the first European multicenter randomized trial of maternal-fetal surgery were slowly being brought into light.

Now as before, and perhaps for many years to come, we will struggle to position ourselves in any serious and inclusive attempt at articulating and debating the moral implications of maternal-fetal therapy, especially in the most invasive of cases, when pregnant women are asked (and agree) to participate in experimental surgery for the sake of their offspring. For this reason alone, but one could add more, the CEG report is a very useful reflective tool. One thing is for sure, fetal therapy will always be a pregnant women’s health issue and that is clearly one of the most important messages of the CEG’s report.

Portret Catarina Rodrigues

Catarina Rodrigues, PhD , is gast-auteur vanwege haar expertise op het thema. Zij promoveerde op de PhD thesis Who’s the patient? Ethics in and around maternal-fetal surgery. Groningen 2012. Op dit moment is zij werkzaam bij het European Research Institute for the Biology of Ageing (ERIBA-UMCG) en is zij lid van de medisch-ethische toetsingscommisie (METC) van het UMCG, Groningen.