The fetus as a patient: A sustainable approach for clinical interactions in the field of new prenatal medicine?

Pregnant women and physicians have not only a rather short common history but also one fraught with tension. The central category of medicine as a professional practice - the category of disease - triggers and justifies professional actions but does not seem appropriate for the vast majority of pregnancies. The state of pregnancy is not a state of disease, neither in a descriptive nor in an evaluative sense. Nevertheless, being pregnant nowadays for many women means being in need of or receiving health care, being a patient. Sophisticated clinical care pathways equipped with extensive sets of diagnostic tools have been established in order to monitor the progress of pregnancies and identify potential complications as early as possible. In many countries, a doctor (and not a midwife) is the key contact person for women during pregnancy. But not only have pregnant women been transformed into patients: increasingly, physicians are identifying the fetus as also being a patient requiring prenatal care. Fetuses themselves are subjected to diagnosis and to treatment. Their whole genome is analysed; they are anesthetized and operated on. Fetuses might even impress as prime work objects in medicine; they are challenging bodies that do not challenge clinicians socially. That is, fetuses cannot ask questions about their own illness or prognosis, nor can they disagree with a doctor’s recommendation. (…) Fetal patients may well be considered the ‘best’ patients by medical workers.