Consent for Pregnancy Termination in Ovarian Cancer
Consent must be obtained from the patient alone. The pregnant woman is the sole decision-maker regarding her medical treatment, including pregnancy termination, regardless of her husband's wishes 1.
Legal and Ethical Framework
The patient has autonomous decision-making authority over her own body and medical care, and spousal consent is neither legally required nor ethically appropriate for medical procedures including pregnancy termination 1.
Healthcare providers should counsel the patient directly about her diagnosis, prognosis, treatment options, and the risks and benefits of continuing versus terminating the pregnancy 1, 2.
The husband's refusal does not override the patient's right to make her own medical decisions, as the pregnant woman bears the physical risks and health consequences of treatment decisions 1.
Clinical Context for This Case
Advanced-stage ovarian carcinoma diagnosed at 15-18 weeks gestation warrants consideration of pregnancy termination to allow optimal maternal treatment without delay 1.
If termination is recommended, the patient should be counseled that delaying treatment to continue pregnancy may compromise her survival, though platinum-based chemotherapy including paclitaxel can be administered after the first trimester if she wishes to preserve the pregnancy 1.
The optimal therapeutic strategy should be jointly chosen by the medical team and patient, with decisions depending on gestational age, cancer stage, treatment options, and the patient's informed wishes 1.
Practical Approach to This Situation
Meet with the patient privately to ensure she can express her wishes without coercion or pressure from family members 1.
Provide comprehensive counseling covering short- and long-term maternal health risks, risks/benefits of pregnancy continuation versus termination, and all available treatment options 2.
Document the patient's informed consent for whichever treatment path she chooses after receiving complete information about her prognosis and options 2.
If the patient chooses termination against her husband's wishes, proceed with her consent alone, as this is both legally and ethically appropriate 1.
Common Pitfall to Avoid
- Do not delay counseling or treatment while attempting to obtain spousal agreement, as delays can directly impact treatment success rates, disease progression, and maternal survival 2.