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Professional Ethics in Obstetrics and Gynecology Professional Ethics in Obstetrics and Gynecology
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Chapter 11 - Periviability

from Section 3 - Professionally Responsible Clinical Practice

Published online by Cambridge University Press:  01 November 2019

Laurence B. McCullough ,
John H. Coverdale  and
Frank A. Chervenak
Laurence B. McCullough
Affiliation:
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
John H. Coverdale
Affiliation:
Baylor College of Medicine, Texas
Frank A. Chervenak
Affiliation:
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Summary

This chapter provides an ethical framework to guide decision making about periviable birth.

Viability in professional ethics in obstetrics and gynecology is a function of both fetal physiology and available resuscitation and life-sustaining treatment. Viability is therefore the biological capacity of a live-born infant to survive even if full technological support is needed. This is the concept of viability used by the United States Supreme Court in its landmark ruling, Roe v. Wade, in 1973.

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Professional Ethics in Obstetrics and Gynecology , pp. 139 - 146
Publisher: Cambridge University Press
Print publication year: 2019

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References

Chervenak, FA, McCullough, LB, Levene, MI. An ethically justified, clinically comprehensive approach to peri-viability: gynaecological, obstetric, perinatal, and neonatal dimensions. J Obstet Gynaecol 2007; 21: 3–7.CrossRefGoogle Scholar
Roe v. Wade, 410 U.S. 113 (1973).
Oklahoma State Department of Health. Definition of Live Birth. Available at www.ok.gov/health/Birth_and_Death_Certificates/Birth_and_Death_Registration_(ROVER)/Stillbirth_Registration_Training/Definition_of_Live_Birth.html (accessed March 1, 2019).
World Health Organization. 1950 definition of live birth. Available at www.gfmer.ch/Medical_education_En/Live_birth_definition.htm (accessed March 1, 2019).
Tyson, JE, Parikh, NA, Langer, J, et al. Intensive care for extreme prematurity – moving beyond gestational age. N Engl J Med 2008; 358: 1672–1681.CrossRefGoogle ScholarPubMed
Eunice Kennedy Shriver National Institute of Child Health and Human Development. NICHD Neonatal Research Network (NRN). Extremely preterm birth outcome data. Available at www1.nichd.nih.gov/epbo-calculator/Pages/epbo_case.aspx (accessed March 1, 2019).
American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. Ecker, JL, Kaimal, A, Mercer, BM, Blackwell, SC, et al. Obstetric Care Consensus. #6 Periviable Birth. Obstet Gynecol 2017; 130: e187–e198.Google Scholar
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American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine. Obstetric Care Consensus, Number 6: Periviable Birth. Obstet Gynecol 2017; 130: 926–928.CrossRef
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American Academy of Pediatrics. Katz, AL, Webb, SA, AAP Committee on Bioethics. Informed consent in decision-making in pediatric practice. Pediatrics 2016; 138: e20161485.CrossRefGoogle ScholarPubMed
Skupski, DW, McCullough, LB, Levene, M, Chervenak, FA. Improving obstetric estimation of outcomes of extremely premature neonates: an evolving challenge. J Perinat Med 2010; 38: 19–22.CrossRefGoogle Scholar
Brett, AS, McCullough, LB. When patients request specific interventions: defining the limits of the physician’s obligation. N Engl J Med 1986; 315: 1347–1351.CrossRefGoogle ScholarPubMed
Brett, AS, McCullough, LB. Addressing requests by patients for nonbeneficial interventions. JAMA 2012; 307: 149–150.CrossRefGoogle ScholarPubMed
Whitney, SN, McCullough, LB, Frugé, E, McGuire, AL, Volk, RJ. Beyond breaking bad news: the roles of hope and hopefulness. Cancer 2008; 114: 442–445.CrossRefGoogle Scholar

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