Abstract

Gregg and Hutchinson (p 1059) tell of 15 infants who would probably have died as fetuses save for intrauterine exchange transfusion and who, at an average age of 2 years, have normal physical and mental development. Their report confirms the hopes that have led mothers and physicians to accept risks, discomforts, and complications in order that the techniques of intrauterine exchange transfusion might be developed and refined. The report will also be a stimulus for the many who have watched such studies with reservations to undertake treatment of the unborn child with isoimmune hemolytic disease. Most important, however, the report will compel us to enlarge our concepts of the patient-doctor contract, the contract that exists whenever there is a sick patient and a doctor who will provide care. The qualities of choice, knowledge, and direct interaction that are crucial to the doctor-patient relationship are not basic to the patient-doctor contract.

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