PSYCHOLOGICAL EFFECTS AND ETHICAL IMPLICATIONS OF THE PRENATAL DIAGNOSIS OF SEVERE MALFORMATION IN THE FETUS

PSYCHOLOGICAL EFFECTS AND ETHICAL IMPLICATIONS OF THE PRENATAL DIAGNOSIS OF SEVERE MALFORMATION IN THE FETUS (Abstract): Considered from the standpoint of the parents’ and medical team’s rights, the prenatal diagnosis of severe inborn malformations is an ethical and legal must, which carries a twofold meaning: recognition of the women’s right to abortion and fetus protection. The purposes of our paper are: to reveal the psychological effect of antenatal diagnosis in case of fetal malformation; to point out a series of ethical implications of elective abortion of fetuses or discontinuation of the treatment of newborns suffering from multiple malformations; and to draw attention on the low antenatal diagnosis rates in our country. Material and methods: In Romania, on a 23-year-long study conducted over 115 neonates suffering from gastroschisis and on 105 newborns with omphalocele, the rate of antenatal malformation diagnosis was very low, and implicitly leaded to a high malformation and chromosomal aberration incidence and hence to a high neonatal mortality rate. Also, the birth of these babies set a considerable financial burden on pediatric surgery wards for the somewhat hopeless treatment. Results: Most of the times, making abortion decisions, caring for or discontinuing the treatment of newborns suffering from multiple malformations also have a negative impact on the family. Whichever the case, any choice made about an abnormal fetus should be respected and protected by the family, the laws in effect and the country’s culture and social structures. Conclusions: It is the parents who should decide the future of the pregnancy or, when there was no antenatal diagnosis, of the neonate; the decision must be made after having been well informed by a multidisciplinary medical team.