The Australian Medical Association (AMA) has publically submitted its Position Statement on maternal decision making. The Position Statement expressly states that a pregnant woman, like any other human being, is entitled to certain human rights – this includes, but is not limited to, the right to privacy and bodily integrity. A pregnant woman should have the autonomy to make her own informed decisions and behave as she sees fit, so long as her actions remain within the legal framework.
Pregnant women are inherently connected to their foetus in a multitude of ways. As such, the decisions that they make for themselves often have the same ramifications for their foetuses. For example, if a woman chooses to eat healthily, then the proteins and nutrients of that food will be passed to the foetus, and benefit the baby’s health. Alternatively, if a woman chooses to abuse alcohol or other substances, then that could pose a significant threat not only to the woman, but to her foetus.
However, occasions arise where the choices that these women make for the benefit of themselves can be harmful to the foetus. For example, the woman may need to undergo a Caesarean-section in order to safely delivery her baby, however this surgery could pose a threat to her own health. In such rare occasions, women are faced with the conflicting choice of protecting themselves or their foetuses. The AMA has stated that women have the right to make an informed decision. That is, when a woman finds herself in such a situation, her doctor should provide her with all the necessary information. The doctor should inform her of all the treatments available to her, and the ramifications that these treatments could possibly have on herself or her foetus. It is up to the woman, thereafter, to weigh the pros and cons and make the decision. Her fully informed decision should be respected by her loved ones, her doctor and the legal system.
Issues often arise where the woman’s decision is contrary to the advice of the doctor. In that case, the doctor should not pressure her; rather, he/she should consider the reasons as to why the patient has chosen that path. If a doctor feels that they cannot continue to care for the patient or act in good faith, then they should refer the patient to another doctor and make arrangements for the ongoing health of the patient.
Where a doctor feels that the patient is not mentally-sound enough to make her own decision, then an assessment should be conducted at the earliest time possible. If indeed the pregnant woman does not meet the required threshold, then her decision-making rights should be referred to an appropriate guardian.