Maternal-fetal conflict can occur in situations where the mother denies health recommendations (e.g. blood transfusions, surgical procedures, cesarean section) that can benefit the fetus or make life choices (e.g. smoking, drinking alcohol, drugs, hazardous exposure) that can harm the fetus.
[1] With advances in technology, healthcare providers are able to access the fetus directly (e.g. sampling fetal blood, urine, other tissue, etc.
[4] When making these decisions from the perspective of 'duality', it is necessary to determine the burdens and benefits of the mother and fetus separately.
[1] One view is that a fetus has rights when it has an independent moral status from its mother, but some ethicists cannot agree on when this occurs.
The viability of a fetus separate from its mother may confer an independent moral status.
For example, a low-income mother may not be able to afford nutritious meals resulting in circumstance playing a role in maternal-fetal decisions.
[2][5] This mentality allows decision-makers to best understand both patients's perspectives, and acknowledge the best interests for both the mother and their fetus.
[3] Decision-making is individualized based on prognosis, gestational age, and the pregnant woman's life and values.
[1] Physicians must prioritize the mother's rights and autonomy as well as understand the value of beneficence and non-maleficence.
[4] In the viewpoint of a maternal-fetal dyad, the mother is both a proxy for the best interest of the fetus and also separately the decision maker for herself as a patient.
[5] The best way to establish a patient-physician relationship is by following best practices, conducting informed consent discussions, preparing for any situation that may arise, offering an alternate provider, compromise, providing documentation (e.g. medical record of information, treatment options, recommendations, etc.
[6][1] There are legal obstacles that make it difficult for the law to be involved in decision making for maternal-fetal conflict, which include the fetus having no rights, court standards being vague and flexible, discrimination towards disadvantage women, and the inability to force a woman to do things that are not required from anyone else (e.g. non-pregnant women, men, etc.).
[3] Because of these legal obstacles, law-makers and judges tend to prioritize women's rights to make their own decision.
[6] According to Kelly Lindgren's journal, Maternal–Fetal Conflict: Court-Ordered Cesarean Section, “poor, minority women are affected most often by court-ordered c-section [...] which include: 47% Black Americans, 33% from Asia or Africa, and only 20% White.”[6] It is also important to address that no other group of people are forced to do anything, so it is questioned why a woman who is pregnant should be forced.
[3] Principle-based theory is defined as "respect for patient autonomy, beneficence non-maleficence, and justice to guide conflict resolution.
"[3] Conflict-based theories emphasize women's rights to autonomy and the physician's moral obligation to both the woman and the fetus separately.
[3][5] In terms of maternal-fetal conflict, it emphasizes understanding the patient's values and experiences to best support her decisions.
[3] M. C. Reid's journal, "The case of Medea—a view of fetal-maternal conflict" alludes to the Greek Myth of Medea as it addresses maternal-fetal scenarios.
For example, a surgeon does an intervention because they are sadistic, but the procedure helps the patient resulting in a good act, but with vicious intent.