Or child could be crippled for life and doctor would be responsible for its continuous agony throughout life2. It will be either like an abortion, or like permitting a child to be born without proper health, even though alternatives exist. Many ethical and moral issues are connected with abortion like the rights of foetus,3 and mother's self-determination that should not be questioned. I am also well aware of the fact that the foetus is already very weak and might not survive the entire gestation period without hospitalisation and continuous monitoring, or even might be born after that with certain milder chronic problem.
I could try to find another physician and transfer the case to him as it is. This would be risky too, because physician might not be willing to take the burden. It could work well in another way, because the mother will get a cooling-off period to reconsider her hasty decision so that she could be sure that she could live with such a decision for the rest of her life4. If I don't make her understand all implications and alternatives, I could be charged of post-conception harm, for not only informing the mother the risks of discontinuing the pregnancy (which I have already done), but also the harm that could come to the foetus by indefinitely prolonging the pregnancy without proper treatment for foetus. Professional duty and ethical confusion will plague this issue as this is an ethical as well as medical dilemma for me to be torn between the two.
I can also refuse to abide by her wishes and try to obtain a court order to force her to undergo treatment. No doubt, this is perhaps a semi-legal way to do it, because foetal rights are not yet fully recognised as against the rights of mother, and this course of action would never work properly5. A resentful mother cannot be forced to have the baby, or to look after it with genuine affection after it is born. It will also jeopardise baby-mother bonding and an awfully strained relationship will develop between the two. It is also doubtful if I would be able to get the court order forcing Ms. White to undergo treatment and retain her pregnancy. There exists an unending argument whether the foetus right is more important or the mother's health. There had been no solution till now, even though as it is today, mother's right is recognised more than that of the foetus.
I can go for Five step process of ethical decision making after taking into consideration all existing issues that have caused ethical distress and dilemma to medical fraternity by being forced to choose between woman's right to self-determination and right to life of the child. I have to consider Ms. White's psychological and physical wellbeing too before making a decision. Usually the child's right is rather suppressed. But to some extent, ethical consideration of women's right too is rationalized. Here foetal disability does not exist, though pointers towards it are present; but there is reasonable assumption that with the continuation of treatment, the child should be benefited and normal. Ethics is an essential dimension of clinical practice and we cannot totally ignore it. Ethical issues get