Clinical opinionObstetricsThe professional responsibility model of obstetrical ethics: avoiding the perils of clashing rights
Section snippets
Fallacy of rights-based reductionism
The fallacy of rights-based reductionism can be understood by analogy to the fallacy of biologic reductionism or oversimplification of scientific models of disease and health. As an antidote to biologic reductionism in medicine, George Engel made a sentinel contribution with his introduction of the biopsychosocial concept of health and disease.6, 7, 8, 9 In his classic paper in Science, Engel summarized the biomedical model:
The dominant model of disease is biomedical, with molecular biology
Professional responsibility model of obstetrics ethics
Because they are fallacious, rights-based reductionism models distort the fundamental nature of the relationship of a physician to his or her patients, a relationship of professional ethical obligations (Table). The professional obligations of the obstetrician-gynecologist originate in the ethical concept of medicine as a profession. This concept was introduced into the history of medicine by 2 remarkable British physician-ethicists: John Gregory (1724-1773) of Scotland and Thomas Percival
Conclusion
The Scylla and Charybdis of rights-based reductionism models should be abandoned and replaced by the professional responsibility model. By basing obstetric practice on the professional responsibility model of obstetric ethics, the obstetrician creates a solid foundation for the care of the pregnant and fetal patient: the physician-patient relationship as a professional commitment.
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The authors report no conflict of interest.
Reprints not available from the authors.
Cite this article as: Chervenak F, McCullough LB, Brent RL. The professional responsibility model of obstetrical ethics: avoiding the perils of clashing rights. Am J Obstet Gynecol 2011;205:315.e1-5.