Differing Attitudes Toward Fetal Care by Pediatric and Maternal-Fetal Medicine Specialists

Abstract

Pediatric and obstetric specialists differ considerably regarding pediatric specialists' role in prenatal care for maternal conditions, and regarding whether to seek judicial intervention for maternal refusal of recommended treatment.

Does professional orientation predict ethical sensitivities? Attitudes of paediatric and obstetric specialists toward fetuses, pregnant women and pregnancy termination

“…We further demonstrated different attitudes between these providers regarding management of several common maternal complications of pregnancy, and regarding the appropriateness of seeking court interventions for maternal refusal of recommended prenatal interventions in three specified clinical scenarios 13. These provider differences may have related to their experiences specific to these conditions.…”

“…This study's limitations have been described previously 12 13. Some are inherent to survey research in which non-response and selection biases may influence outcomes, and in which physician behaviour is measured indirectly.…”

“…This study's methods have been previously described in detail 12 13. From November 2009 to February 2010 we mailed confidential, self-administered questionnaires, up to three times, to FCP and MFM specialists in 21 states.…”

“…Some paediatrics hospitals house internal units for delivery and perinatal maternal care. Our previous work demonstrated that obstetric and paediatric specialists who practice prenatal care have differing attitudes regarding numerous aspects of pregnancy management when certain fetal and maternal conditions are diagnosed 12 13. It is unclear whether such differences represent divergent understandings of how certain fetal and maternal conditions behave clinically, or whether these differences may be associated with distinct, professionally-associated convictions about the ethical appropriateness of alternate management options for such conditions.…”

A survey of fetal care centers in the United States

“…They also note that specialists working in the fetal center are often employed by the same children's hospitals where infants born with complex anomalies would be treated at great expense; this might create the potential for subtle conflicts of interest [1]. An additional concern may be that clinicians from different subspecialties may balance maternal and fetal interests dissimilarly due to differences in their training or professional obligations [2,8,9]. This issue could be especially significant when fetal surgical interventions are being considered.…”