%0 Journal Article %A Dominic Wilkinson %T Fatal fetal paternalism %D 2012 %R 10.1136/medethics-2012-100542 %J Journal of Medical Ethics %P 396-397 %V 38 %N 7 %X Heuser and colleagues' survey of obstetricians provides a valuable insight into the current management of severe fetal anomalies in the United States. Their survey reveals two striking features - that counselling for these anomalies is far from neutral, and that there is significant variability between clinicians in their approach to management. In this commentary I outline the reasons to be concerned about both of these. Directiveness in counselling arguably represents a form of paternalism, and the evident variability in practice is likely the result of physician personal values. However, Heuser's survey may, by shining a light on practice, provide an important step towards a more consistent approach. %U https://jme.bmj.com/content/medethics/38/7/396.full.pdf