Ethically justified guidelines for family planning interventions to prevent pregnancy in female patients with chronic mental illness

Case report: the story of schizophrenic patient from renal colic to childbearing

“…[7] Ancak, çocuk doğurmanın psikiyatrik hastalığı olan kadınların sağlığını koruması ya da psikiyatrik hastalıklara yatkınlık yaratması ile ilgili çok az şey bilinmektedir. [8] Prospektif bir çalışmada, şizofrenlerin çocuklarında fetal ve neonatal ölüm oranlarında artış olduğu bildirilmiştir. [9] Bir başka çalışmada prematurite, düşük doğum ağırlığı, düşük APGAR skorunun ruhsal hastalıkların şiddetiyle ilişkili olduğu saptanmıştır.…”

Family Planning and the Scope of the “Reproductive Psychiatry” Curriculum

“…A preventive ethics strategy involves proactively discussing family planning with patients with mental disorders in order to reduce the risk of ethical dilemmas and adverse ethical outcomes [50]. Key components of an ethical framework for preventing unwanted pregnancies in patients with major mental disorders include balancing autonomy and beneficence-based obligations to the patient [51,52]. It has not been shown that coercing or manipulating a patient's decision-making regarding contraception is ethically justified when at risk of unwanted pregnancies, even when the patient has impaired decisionmaking [51,52].…”

“…Key components of an ethical framework for preventing unwanted pregnancies in patients with major mental disorders include balancing autonomy and beneficence-based obligations to the patient [51,52]. It has not been shown that coercing or manipulating a patient's decision-making regarding contraception is ethically justified when at risk of unwanted pregnancies, even when the patient has impaired decisionmaking [51,52]. Although long-acting reversible contraception methods are highly effective and safe for use in almost all women [53], potential ethical problems occur when these are not removed at a patient's request.…”

The Cornell University Experience

“…Our research has therefore addressed a wide range of topics in clinical obstetrics and gynecology including the limits of viability [67], mental health and pregnancy [68][69][70][71][72][73][74][75][76], cesarean delivery [77,78], patient's refusals of medically indicated management [29,35,38], assisted reproductive technology [79,80], obstetric anesthesia [81], cancer during pregnancy [82,83], HIV infection [84], issues in gynecology [85,86], the language that should be used in decision making with patients [87], advance directives [29,82,83] and professional issues [88].…”