Regulating medical decision-making: A qualitative study of fetal reduction in multiple pregnancy

Authors: Wale, J.

Start date: 17 September 2019

This research uses a narrow contextual focus (multiple pregnancy), places a spotlight on a specialist set of medical procedures (fetal reduction) operating in a unique regulatory environment and complicated by a polarised range of socio-political factors. In doing so, the research has been able to explore medical decision-making in a situationally centred context unavailable using a broader landscape or a different research lens. Specifically, the use of qualitative research methods and interview data from key stakeholders, in combination with a critical realist lens, has enabled the research to address the particular power dynamics of these clinical encounters. In this work, we have pursued three central lines of inquiry: first, to understand more about the nature of fetal reduction in multiple pregnancy, its frequency, and the legal ground(s) for termination on which doctors typically rely; secondly, to assess the extent to which legal, ethical and professional norms guide and constrain this particular kind of decision-making; and, thirdly, to evaluate the adequacy of these norms and to explore possible solutions. Our jurisdictional context is England and Wales.

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