Documenting moral agency: a qualitative analysis of abortion decision making for fetal indications

Contraception. 2017 Feb;95(2):175-180. doi: 10.1016/j.contraception.2016.08.020. Epub 2016 Sep 6.

Abstract

Objectives: We explored whether the decision-making process of women aborting a pregnancy for a fetal indication fit common medical ethical frameworks.

Study design: We applied three ethical frameworks (principlism, care ethics, and narrative ethics) in a secondary analysis of 30 qualitative interviews from women choosing 2nd trimester abortion for fetal indications.

Results: All 30 women offered reasoning consistent with one or more ethical frameworks. Principlism themes included avoidance of personal suffering (autonomy), and sparing a child a poor quality of life and painful medical interventions (beneficence/non-maleficence). Care ethics reasoning included relational considerations of family needs and resources, and narrative ethics reasoning contextualized this experience into the patient's life story.

Conclusions: This population's universal application of commonly accepted medical ethical frameworks supports the position that patients choosing fetal indication abortions should be treated as moral decision-makers and given the same respect as patients making decisions about other medical procedures.

Implications: These findings suggest recent political efforts blocking abortion access should be reframed as attempts to undermine the moral decision-making of women.

Keywords: Abortion; Fetal anomaly; Medical ethics; Stigma.

MeSH terms

  • Abortion, Induced* / ethics
  • Adult
  • Decision Making / ethics*
  • Ethics, Medical*
  • Female
  • Fetal Diseases*
  • Humans
  • Morals
  • Pregnancy
  • Pregnancy Trimester, Second
  • Quality of Life