Obstetrics & Gynecology>>>>>Ethical and Legal Issues in Obstetrics and Gynecology
Question 21#

Ms Jones is a 28-year-old woman who has agreed to be a gestational surrogate for a couple who cannot bear children. She presents to your office for prenatal care.

Which of the following is your responsibility as an obstetrician caring for a gestational surrogate?

a. Consult with intended parents regarding all clinical interventions and management of the pregnancy
b. Discuss the health of the surrogate and progress of the pregnancy with the intended parents without consent of the surrogate mother
c. Make recommendations for prenatal care in accordance with the agreement between the gestational surrogate and the intended parents
d. Only provide prenatal care to her, if the adoptive mother is also your patient
e. Provide appropriate care regardless of the patient’s plans to keep or relinquish the future child

Correct Answer is E

Comment:

When a pregnant surrogate seeks medical care for an established pregnancy, the obstetrician should explore with the surrogate her understanding of her legal agreement with the intended parents. She should be cared for as any other obstetrical patient. The obstetrician’s professional obligation is to support the well-being of the pregnant woman and her fetus, and to provide appropriate care regardless of her plans to keep or give up the baby. The pregnant surrogate should be the one to give consent regarding treatment of the pregnancy in the clinic or on labor and delivery. The obstetrician should make treatment decisions that are in the best interest of the surrogate and her fetus, regardless of the agreement between her and the intended parents. Patient confidentiality should be maintained. The patient’s medical information should only be given to the intended parents with the surrogate’s explicit consent. The obstetrician should avoid conflicts of interest and should not facilitate a woman’s becoming a gestational surrogate for a couple for whom the physician is treating.