Ethical considerations concerning amnioinfusions for treating fetal bilateral renal agenesis

Jeremy Sugarman, Jean Anderson, Ahmet A. Baschat, Jaime Herrera Beutler, Jessica L. Bienstock, Timothy E. Bunchman, Niraj M. Desai, Elena Gates, Aviva Goldberg, Paul C. Grimm, Leslie Meltzer Henry, Eric B. Jelin, Emily Johnson, Christine B. Hertenstein, Anna C. Mastroianni, Mark R. Mercurio, Alicia Neu, Lawrence M. Nogee, William J. Polzin, Steven J. RalstonRonald M. Ramus, Megan Kasimatis Singleton, Michael J.G. Somers, Karen C. Wang, Renee Boss

Research output: Contribution to journalArticle

Abstract

Congenital bilateral renal agenesis has been considered a uniformly fatal condition. However, the report of using serial amnioinfusions followed by the live birth in 2012 and ongoing survival of a child with bilateral renal agenesis has generated hope, but also considerable controversy over an array of complex clinical and ethical concerns. To assess the ethical concerns associated with using serial amnioinfusions for bilateral renal agenesis, we assembled a multidisciplinary group to map the ethical issues relevant to this novel intervention. The key ethical issues identified were related to 1) potential risks and benefits, 2) clinical care compared with innovation compared with research, 3) counseling of expectant parents, 4) consent, 5) outcome measures, 6) access and justice, 7) conflicts of interest, 8) effects on clinicians, 9) effects on institutions, and 10) long-term societal implications. These ethical issues should be addressed in conjunction with systematic efforts to examine whether this intervention is safe and effective. Future work should capture the experiences of expectant parents, women who undergo serial amnioinfusions, those born with bilateral renal agenesis and their families as well as clinicians confronted with making difficult choices related to it.

Original languageEnglish (US)
Pages (from-to)130-134
Number of pages5
JournalObstetrics and gynecology
Volume131
Issue number1
DOIs
StatePublished - Jan 1 2018

    Fingerprint

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Sugarman, J., Anderson, J., Baschat, A. A., Herrera Beutler, J., Bienstock, J. L., Bunchman, T. E., Desai, N. M., Gates, E., Goldberg, A., Grimm, P. C., Henry, L. M., Jelin, E. B., Johnson, E., Hertenstein, C. B., Mastroianni, A. C., Mercurio, M. R., Neu, A., Nogee, L. M., Polzin, W. J., ... Boss, R. (2018). Ethical considerations concerning amnioinfusions for treating fetal bilateral renal agenesis. Obstetrics and gynecology, 131(1), 130-134. https://doi.org/10.1097/AOG.0000000000002416