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  • Title: Commentary: self interest is not the sole legitimate basis for making decisions.
    Author: Weijer C.
    Journal: BMJ; 1998 Mar 14; 316(7134):850. PubMed ID: 9549462.
    Abstract:
    The treatment of cancer in pregnant patients involves difficult decisions about abortion, the best treatment options, and the potential benefits of treatment to the mother versus risks to the fetus. Most of the discussion about these decisions has focused on cases where a mother has refused an intervention that would potentially save her fetus, such as the case of Angela Carter, who was terminally ill with cancer and refused to undergo a Cesarean section at 26.5 weeks gestation. In this case, both mother and child died after a court-ordered Cesarean was performed. A higher court later overturned this ruling and stated that the pregnant woman should be allowed to decide on her treatment in virtually all cases. In a similar case, a mother with melanoma chose to continue her pregnancy even though this decision precluded some treatment options and caused her to refuse even the use of analgesics after bone metastases. While it is tempting to regard such a decision as the result of "internal coercion," it is important to recognize that people make many decisions based on the best interests of others. Thus, a decision to sacrifice treatment options in an attempt to salvage a healthy child should be considered voluntary and valid.
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