AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. September 2013, Volume 15, Number 9: 741-823.

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September 2013 Contents

Motherhood and Medicine

Ethics Poll

Pregnant women are excluded from participation in most drug trials because of the unknown effects drugs may have on the fetus. Yet women often need drugs during their pregnancies and are prescribed FDA-approved drugs that were not tested on pregnant women. Which of the following do you think is the best resolution of this dilemma?
Competent pregnant women, adequately informed of the risks and benefits of the trial, can consent to take part in the trial. Trial conditions and monitoring are safer than the conditions under which they will take drugs if they need them while pregnant.
No pregnant woman should be allowed to consent to participation in a trial in which risk of harm to her fetus is unknown.
Pregnant women should not take part in drug trials, nor should they be prescribed drugs during pregnancy if those drugs are not known to be safe for a developing fetus.
Donít know.

Women medical students and resident physicians are in school and training during the years when pregnancy is most easily achieved and childbearing is safest. The best solution for women who are becoming physicians and want to have children is:
Women physicians-to-be should finish school and training before having children.
About half of all medical students and residents are women, so it makes sense to create flexible medical school curricula and residency schedules for women who wish to become pregnant during those years.
Day care centers and mothersí rooms should be standard features of medical schools and teaching hospitals.
Women who want to be physicians and mothers should have children before entering medical school.
Donít know.

Lactation can usually be induced in women who are not pregnant, and it often is for women who want to breastfeed an adopted baby. In a lesbian couple, the nongestating woman wants to be able to breastfeed the baby and asks the obstetrician to induce lactation for her. Which of the following best describes what you think about this request?
In the absence of a risk to the specific womanís health, the obstetrician should provide the requested medical service.
The obstetrician should try to discover why the woman who is making the request wants to breastfeed the baby.
The obstetrician should discourage the woman because the intervention is not medically necessary: a baby only needs one nursing mother.
Donít know. (To learn what ethics experts think about this question, see case 2 in the September 2013 issue of VM).


From the Editor

Motherhood and Medical Ethics: Looking beyond Conception and Pregnancy
Colleen Farrell
Full Text | PDF
Virtual Mentor. 2013; 15:743-745.

Educating for Professionalism

Ethics Cases

Weighing Risks and Benefits of Prescribing Antidepressants during Pregnancy
Commentary by Benjamin C. Silverman and Anne F. Gross
Full Text | PDF
Virtual Mentor. 2013; 15:746-752.

Induced Lactation for the Nongestating Mother in a Lesbian Couple
Commentary by Lance Wahlert and Autumn Fiester
Full Text | PDF
Virtual Mentor. 2013; 15:753-756.

Mentoring Students about Career and Life
Commentary by Kate Treadway
Full Text | PDF
Virtual Mentor. 2013; 15:757-760.

Journal Discussion

Whose Hands? Global Migration, Elder Care, and the Mothers of Others
Nancy Berlinger and Rebecca Kaebnick
Full Text | PDF
Virtual Mentor. 2013; 15:761-766.

State of the Art and Science

Epigenetic Inheritance and the Moral Responsibilities of Mothers
Kristen Hessler
Full Text | PDF
Virtual Mentor. 2013; 15:767-770.

Law, Policy, and Society

Health Law

Ferguson v. City of Charleston and Criminalizing Drug Use During Pregnancy
Yesenia M. Perez
Full Text | PDF
Virtual Mentor. 2013; 15:771-774.

Policy Forum

Mothers Matter: Ethics and Research during Pregnancy
Anne Drapkin Lyerly and Ruth R. Faden
Full Text | PDF
Virtual Mentor. 2013; 15:775-778.

Shackling and Separation: Motherhood in Prison
Jennifer G. Clarke and Rachel E. Simon
Full Text | PDF
Virtual Mentor. 2013; 15:779-785.

Medicine and Society

The Difference between Science and Technology in Birth
Aron C. Sousa and Alice Dreger
Full Text | PDF
Virtual Mentor. 2013; 15:786-790.

History, Art, and Narrative

History of Medicine

Breast Pumping
Jessica Martucci
Full Text | PDF
Virtual Mentor. 2013; 15:791-797.

Medical Narrative

A Life of Mothering
Sidney Callahan
Full Text | PDF
Virtual Mentor. 2013; 15:798-800.

Op-Ed and Correspondence


The Ghost of the Schizophrenogenic Mother
Josephine Johnston
Full Text | PDF
Virtual Mentor. 2013; 15:801-805.


Suggested Readings and Resources
Virtual Mentor. 2013; 15:806-819.

About the Contributors
Full Text | PDF
Virtual Mentor. 2013; 15:820-823.