This book provides the first clinically comprehensive and practical approach to ethical challenges in perinatal medicine. The first chapter introduces and explains the professional responsibility model of perinatal ethics. The professional responsibility model is based on the medical ethics of two major physician-ethics in the history of Western medical ethics, Dr. John Gregory (1724-1773) of Scotland and Dr. Thomas Percival (1740-1804) of England. The professional responsibility model is used to articulate the ethical concept of the fetus as a patient and to operationalize the ethical principles of beneficence and respect for autonomy. The book provides practical guidance for clinical judgment and decision making with patients about the responsible clinical management of the wide range of issues encountered by perinatologists in clinical practice and research. Topics included: periviability; feticide; intrapartum management; maternal-fetal conflict; innovation for fetal benefit; research for fetal benefit; non-aggressive obstetric management; managing the transition from pregnancy to birth; destructive procedures such as cephalocentesis; critical care for the pregnant patient; home birth; patient-choice cesarean delivery; neonatal care as a trial of management; and setting limits on neonatal care on the basis of clinical judgments of futility.
Ultrasound is the backbone of modern obstetric and gynecology practice. Recent technological breakthroughs in diagnostic ultrasound, including the advent of color Doppler, power Doppler, three-dimensional and four dimensional imaging, have led ultrasound to surpass the expectations of Ian Donald, its visionary father. The text is divided into three parts general aspects, obstetrics, and gynecology. The first and second textbooks were successful in this endeavor, but with the explosion of knowledge, it was clear that an expanded and updated third edition would be invaluable. Section one deals with a variety of topics that lay the foundation for the rest of the book. Section two addresses the myriad subtopics in obstetric ultrasound that optimize the care of pregnant women and fetal patients. The last section addresses the essential role that ultrasound plays in the many dimensions of clinical gynecology.
A comprehensive review of problems that may occur during pregnancy and labour. Beginning with antenatal care and surveillance throughout pregnancy, the following chapters discuss various medical conditions that may arise including diabetes, pulmonary and neurological diseases, urinary complications, cardiac disease and endocrine disorders. Several chapters are dedicated to labour and include topics such as instrumental delivery, postpartum problems, haemorrhage and neonatal resuscitation. With contributions from internationally renowned obstetricians, this manual includes more than 400 images and illustrations.
This book offers a comprehensive and clinically practical approach to ethics in the everyday practice of obstetrics and gynecology. The topics the authors address include: contraception, abortion, selective termination of multifetal pregnancies, gynecologic cancer, in vitro fertilization, surrogacy, prenatal diagnosis, fetal therapy, cephalocentisis, prematurity, HIV infection, and court ordered cesarean delivery. The issues involved in making decisions in many of these areas are a source of conflict, and lead to crisis between the physician and patient. One of the book's strengths is its emphasis on prevention and, if prevention fails, management, of the conflicts and crises which arise in these areas of medicine. The authors develop their preventative and management strategies on the basis of a framework for bioethics in the clinical setting. This framework is rigorously established and defended. The authors argue that four virtues -- self effacement, self sacrifice, compassion, and integrity -- generate the physician's obligation to protect and promote the patient's interest. They then identify the three types of patient's interests -- social role interests, subjective interests, and deliberative interests -- and they reinterpret the ethical principles of beneficence and respect for autonomy in terms of these. The concept of the fetus as patient, the physician's obligation to third parties, and the moral standing of fathers and family members are also addressed. The implications of their argument sets the stage for the discussions of prevention and management in the remaining sections of the book. Ethics in Obstetrics and Gynecology is a unique addition to the literature in both biomedical ethics and obstetrics and gynecology. It demonstrates that ethics should be regarded as an essential part of obstetrics and gynecology, and that clinical practice is incomplete without it.
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