When Is Termination of Pregnancy during the Third Trimester Morally Justifiable?

Abstract

The question whether to terminate pregnancy during the third trimester involves a moral conflict. We argue that such termination is morally justifiable if two conditions are fulfilled: first, that the fetus is afflicted with a condition that is either incompatible with postnatal survival for more than a few weeks or characterized by the total or virtual absence of cognitive function; and second, that highly reliable diagnostic procedures are available for determining prenatally that the fetus fulfills either of the two parts of the first condition. At present, one entity, anencephaly, clearly fulfills both conditions. We studied 10 cases involving fetuses with sonographically diagnosed anencephaly that were aborted during the third trimester. We also examined other fetal disorders and conclude that they do not clearly fulfill our two conditions for the justifiable termination of pregnancy in the third trimester.

Feticide during Second- and Third-Trimester Termination of Pregnancy: Opinions of Health Care Professionals

“…Late termination of pregnancy (TOP) raises a number of practical and ethical issues [1][2][3] among which is the need to perform feticide prior to inducing labor when the fetus is potentially viable. This is usually achieved by injecting a lethal medication into the fetal circulation before the induction of labor [4,5], after deep fetal anesthesia has been obtained [6][7][8][9].…”

Medical and ethical considerations in twin pregnancies discordant for serious cardiac disease

“…If the fetuses are regarded as patients, 21 the parents become the decision makers for the medical treatment of their children, and physicians may intervene or override the parental decision if it is clearly detrimental to the twins' best interests. For example, if the affected twin has a minor or readily treatable cardiac condition.…”

Physiologic Assessment of Fetal Compromise: Biomarkers of Toxic Exposure

“…The accuracy of high-resolution ultrasound is of course the critical issue. Anencephaly can be diagnosed with 100% certainty (11). Anomalies (such as alobar holoprosencephaly with absent midline cerebral structures and related hypotelorism) manifested by two or more embryologically related markers, each of which is detectable by ultrasound, can be diagnosed reliably (12).…”

“…Fetal breathing activity can be detected by ultrasonography and other techniques by 11 weeks. By 16 weeks these breathing movements are sufficiently intense to move small amounts of amniotic fluid in and out of the respiratory tract.…”