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

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. Tradit...

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Bibliographic Details
Authors: Radic, Julia a. E. (Author) ; Illes, Judy (Author) ; Mcdonald, Patrick J. (Author)
Format: Electronic Article
Language:English
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Published: Cambridge Univ. Press 2019
In: Cambridge quarterly of healthcare ethics
Year: 2019, Volume: 28, Issue: 3, Pages: 476-487
Further subjects:B myelomeningocele
B surgical innovation
B fetal surgery
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Summary: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.
ISSN:1469-2147
Contains:Enthalten in: Cambridge quarterly of healthcare ethics
Persistent identifiers:DOI: 10.1017/S0963180119000409