Communicating bad news about congenital abnormalities: bioethical and legal considerations

Abstract

The communication to the pregnant woman that her fetus has congenital abnormality is framed by what is meant by bad news, surrounded by ethical conflicts experienced in fetal medicine and neonatology. The couple’s breach of expectations about their idealized child arouses antagonistic feelings; The manner of elaboration of the news and even the eventual decision to terminate the pregnancy will be directly influenced as the fact was communicated by the team. For cases in which the child is born alive, the decision to adopt Palliative Care should also be shared, providing the exercise of responsible parenting. It is common, however, the request by the family of practices that configure dysthanasia and therapeutic obstinacy, when not adequately clarified about the prognosis of the disease. Aspects related to proper communication in the physician-patient relationship are discussed, fundamental to the exercise of autonomy and the duty to inform, whose violation leads to liability in the civil and ethical-professional spheres.