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Fetal Repair of Open Neural Tube Defects: Ethical, Legal, and Social Issues

Published online by Cambridge University Press:  12 July 2019

JULIA A.E. RADIC ,
JUDY ILLES  and
PATRICK J. MCDONALD
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Abstract:

Open neural tube defects or myelomeningoceles are a common congenital condition caused by failure of closure of the neural tube early in gestation, leading to a number of neurologic sequelae including paralysis, hindbrain herniation, hydrocephalus and neurogenic bowel and bladder dysfunction. Traditionally, the condition was treated by closure of the defect postnatally but a recently completed randomized controlled trial of prenatal versus postnatal closure demonstrated improved neurologic outcomes in the prenatal closure group. Fetal surgery, or more precisely maternal-fetal surgery, raises a number of ethical issues that we address including who the patient is, informed consent, surgical innovation and equipoise as well maternal assumption of risk. As the procedure becomes more widely adopted into practice, we suggest close monitoring of new fetal surgery centers, in order to ensure that the positive results of the trial are maintained without increased risk to both the mother and fetus.

Keywords

myelomeningocelefetal surgerysurgical innovation
Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 28 , Issue 3 , July 2019 , pp. 476 - 487
Copyright
Copyright © Cambridge University Press 2019 

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References

Notes

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