Professional ethics of recommendations: implications for COVID-19 vaccination of women who are pregnant or planning to become pregnant

F A Chervenak,A Grunebaum,L B Mccullough

doi:10.47093/2218-7332.2021.12.2.55-61

Abstract

There has been changing guidance from national and international professional associations, national and international non-governmental organizations, and health officials in national governments for obstetrician-gynecologists about COVID-19 vaccination of pregnant women and women who are planning to become pregnant. in this paper, we provide an ethical framework that provides the needed guidance to decision making about recommending COVID-19 vaccination to these patients. the unique feature of this ethical framework is that it is based on professional ethics in obstetrics and gynecology. We begin with an account of three key components of professional ethics in obstetrics and gynecology and how they are pertinent to the ethics of making recommendations that should be understood in obstetric and gynecologic practice generally. We then identify the implications of this overview for the specific topic of the ethics of recommending COVID-19 vaccination.

Highlights

There has been changing guidance from national and international professional associations, national and international non-governmental organizations, and health officials in national governments for obstetrician-gynecologists about COVID-19 vaccination of pregnant women and women who are planning to become pregnant. in this paper, we provide an ethical framework that provides the needed guidance to decision making about recommending COVID-19 vaccination to these patients. the unique feature of this ethical framework is that it is based on professional ethics in obstetrics and gynecology
It should be of considerable concern to obstetrician-gynecologists that currently there is conflicting guidance from national and international professional associations, national and international non-governmental organizations, and health officials in national governments about COVID-19 vaccination of pregnant women and women who are planning to become pregnant. the purpose of this paper is to provide an ethical framework that provides clear guidance to decision making about recommending COVID-19 vaccination to these patients
This conclusion can be made with confidence even in the absence of a randomized clinical trial with pregnant women and women planning to become pregnant in an intervention arm

Summary

КЛЮЧЕВЫЕ ПОЛОЖЕНИЯ

Профессиональная этика в акушерстве и гинекологии должна служить ориентиром для акушеров-гинекологов при консультировании беременных по поводу вакцинации против COVID-19. Shared decision making starts with the patient’s values and beliefs about COVID-19 vaccination, which becomes the controlling factor of the decision-making process This means that the physician has the autonomy-based ethical obligation not to challenge but always to support the decision of the patient, including refusing the COVID-19 vaccination. Making recommendations about COVID-19 vaccination starts with the clinical reality that there is only one medically reasonable alternative, which becomes the controlling factor of the physician’s clinical judgment and in the decision-making process This means that the physician has the ethical obligation to respectfully challenge the decision of a pregnant patient or patient planning to become pregnant to refuse COVID-19 vaccination. This significance increases in countries like Russia with low current vaccination rates

CONCLUSION

ВКЛАД АВТОРОВ