Ethical and medicolegal considerations in the termination of pregnancy due to lethal congenital anomalies in Banda Aceh, Indonesia

Abstract

BACKGROUND: The aim of the following paper is to present the case termination of pregnancy indicated by lethal congenital anomalies based on ethical and medicolegal consideration. The method used to resolve this ethical dilemma is based on clinical ethics theory with systematic consideration of medical indications, patient preferences, quality of life, and contextual features. Medicolegal considerations were also take-into account based on Indonesian Law number 36 of 2009. CASE REPORT: This case report shows the termination of pregnancy in a 26-year-old patient with 25–26 weeks’ gestational age. Unfortunately, the patients are referred too late, so because of limited facilities in the rural area, the presence of congenital abnormalities in the fetus is not detected early in the 1st week of pregnancy. The results of obstetric ultrasonography showed multiple congenital anomalies. The ethical dilemma faced by obstetricians is whether to terminate the pregnancy now or after the fetus has reached term gestational age? RESULTS: The results of ethical and medicolegal considerations in this case were carried out comprehensively by producing a joint decision between the team of doctors, the patient, and her families. The decision was made after providing adequate information regarding medical indications while taking into account the patient’s viewpoint (patient preference), quality of life, and also contextual features.