Ethical issues and decision-making in fetal cardiology.

Background: As the technique of fetal ultrasound has developed, we have more opportunities to perform fetal echocardiography. Our knowledge about fetal diagnosis has been rapidly expanded. It is essential for the pediatricians to understand the ethical issues surrounding the fetal diagnosis.
Methods: We discussed these ethical issues at the 5th Annual Meeting of the Japanese Society of Fetal Cardiology in Fukuoka, Japan, 1999. I have reviewed the ethical issues brought up in the discussions.
Results: We have discussed many aspects of ethical issues. We should explain to parents before the fetal scan how and why the fetus is examined. It is very important to get written informed consent from the parents. It seems very difficult to inform of fetal diagnosis and support parents appropriately. We have to establish a system where obstetricians, neonatologists, cardiologists, nurses, midwives and medical social workers are cooperating in the perinatal center.
Conclusion: We have many problems in the field of ethical issues. We have to keep discussing them. It is necessary to establish a team for fetal medicine in every perinatal hospital.