A review of the ethical and legal principles used in the decision making process for feticides at seven sites in South Africa

Date
2009-11-12T07:18:18Z
Authors
Patel, Bhavna
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Abstract
This study set out to perform an ethical-legal analysis of the current practices across the seven public health centres in South Africa that perform feticide for congenital abnormalities. Ideally, such decisions need to be guided by multidisciplinary discussions with the parent(s) and the parties included in the team, e.g. Obstetricians, Neonatologists, Nursing, Genetics counsellors and Social Workers and following the ethical principles of beneficence and respect for autonomy. Prior to the study, it was unknown as to whether all seven centres were using multidisciplinary groups in the decision-making process and on what basis approvals were being granted for feticide. The objectives of the review were to assess the number of feticides performed, who made the decision to offer the feticide and for what ethical or clinical indications. The results showed that all public health facilities in South Africa differed in the criteria that were used in making the decision to offer feticide. The clinicians varied in terms of who was represented in the team that reviewed the cases of congenital abnormalities. An analysis of the literature, together with a review of the data received on the current practices, guided the development of an ethical guideline for this service as well as making recommendations as to how the law could be strengthened in order to protect both health workers and patients.
Description
M.Sc. (Med.) (Bioethics and Health Law), Faculty of Health Sciences, University of the Witwatersrand, 2009
Keywords
feticide, South Africa, ethics, legal principles
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