Ethical Challenges in the Treatment of a Terminally III Pregnant Woman with Diminished Decision-Making Capacity

摘要

This article highlights the complexity of ethical challenges that can arise in treatment planning for patients with serious medical and mental health conditions. The patient presented here is terminally ill with an acute exacerbation needing an urgent procedure; she is pregnant with a previable fetus and her mental status is unstable, in this case, the role of the psychiatrist extends beyond merely assessing her decision-making capacity; the psychiatrist should also help to identify the patient's values, which, along with the ethical concepts of the fetus as a patient, beneficence, and respect for autonomy, can then guide treatment planning by the care team and the patient's surrogate decision-maker. The psychiatrist can also help to identify countertransference to allow for the least biased decision-making.