Professional ethics and decision making in perinatology

Objective: We describe the essential elements of professional ethics in perinatology and explain how professional ethics in perinatology should guide decision making with pregnant patients and with parents. Findings: Professional ethics in perinatology draws on two ethical principles, beneficence and respect for patient autonomy, the ethical concept of the fetus as a patient, and the best interests of the child standard and the concept of parental permission. Counseling about intrapartum management should be based on the ethical concept of the fetus as a patient and on the role of the pregnant patient as the ultimate decision maker. Counseling about setting ethically justified limits on perinatal clinical management should be based on four specified concepts of futility, but not on quality-of-life futility. Counseling about innovation and research should emphasize that investigation clinical management is an experiment. Conclusion: Professional ethics in perinatology is an essential component of perinatal practice, innovation, and research (C) 2021 Elsevier Inc. All rights reserved.