Resolving the clinical and ethical dilemma involved in fetal-maternal conflicts,

A serious ethical dilemma occurs when a pregnant woman refuses a medically indicated intervention. Should respect for her autonomy preclude any approach other than to accept her decision? Should the caregivers have recourse to “gentle persuasion”? Is there ever a justification for invoking the power of court-ordered intervention? The societal views on this subject are first developed from an ethical perspective. The pertinent court cases that reflect on this topic are reviewed. The process of developing guidelines within our institution is related. Finally, the guidelines that were eventually developed are offered. (Am J Obstet Gynecol 1996;175:289-95.)