Fetocide

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The fetocide refers to the killing and removal of one or more fetuses in the womb. This procedure is used, for example, when the unborn child is disabled or when there are multiple pregnancies .

Indications

Medical indication

According to German law, it is possible to terminate a pregnancy at any stage for medical reasons if the physical or mental health of the mother would be endangered by a live birth and this risk cannot be averted in any other way that is reasonable for her ( 218a II StGB ). In practice, this often refers to cases in which prenatal diagnostic measures such as amniotic fluid puncture revealed a fetal chromosomal disorder such as trisomy 21 or a serious malformation, for example spina bifida aperta . At an advanced stage of pregnancy, when the fetus would be viable outside the uterus, fetocide is performed before an abortion to prevent a live birth. The procedure must be carried out before the onset of the opening labor, as the unborn child is legally considered a person at the beginning of the birth process and the termination of pregnancy at this point in time constitutes a homicidal offense that will be prosecuted.

An abortion for a eugenic indication, however, is not permitted in Germany. This means that for the question of whether a late abortion is legal in an individual case, only the health risk to the mother is decisive. In practice, severe fetal malformations often play a central role, but in a legal sense they are only of indirect importance.

Multiple pregnancy

In the case of triple or higher-grade pregnancies, which usually occur as a result of artificial insemination , a fetocide can be carried out to ensure the survival and development of the remaining fetuses as well as the significantly increased risk of pregnancy complications such as preeclampsia , eclampsia or pregnancy for the pregnant woman to reduce pulmonary embolism . If no genetic defects or differences in the development of the fetus were found in the course of the preliminary examinations, the fetus that is most easily accessible is selected. According to the opinion of the German Medical Association, it is inadmissible to kill more fetuses than is absolutely necessary to avert danger to justify the indication.

execution

Under ultrasound vision, the doctor uses a needle to penetrate the pregnant woman's abdominal wall into the uterus and the amniotic sac . The selected fetus is first given analgesic medication through the umbilical cord blood vessels, followed by the injection of potassium chloride into the fetal heart. The resulting cardiac arrest occurs within a few minutes. In the case of a multiple pregnancy, the killed fetus remains in the uterus until birth, if it has not previously been resorbed by the pregnant woman's body . The frequency of such an intervention is estimated at around 150 cases per year in Germany, but the number of unreported cases is many times higher, not least because the affected parents also seek help abroad.

Prevention

In order to prevent the development of a high-grade multiple pregnancy and thus the number of unnecessary fetocides in the context of sterility treatment, all preventive measures must be taken in advance by the reproductive medicine specialist, according to the recommendation of the German Medical Association . This includes the detailed education of the affected couples, the careful monitoring of the artificially stimulated cycles, the avoidance of hormone overstimulation and the insertion of more than two embryos.

criticism

In particular, fetocide to reduce multiple births is ethically highly controversial. It has been called the darkest chapter in reproductive medicine. Perinatal doctors particularly criticize the sometimes irresponsible approach in the field of sterility treatment, in which the artificial induction of pregnancy has the highest priority and fetocide is taken lightly in advance as a "therapeutic option" for a high-grade multiple pregnancy. In this context they also express that they feel that their function has been abused by eliminating the undesirable side effects of reproductive medicine.

In the context of sterility treatment, affected parents criticize insufficient or trivializing information about the risks of a multiple pregnancy and the consequences that go along with the decision for or against a fetocide. A survey of infertile couples, however, led to the result that the majority of people wanted to have a child and pushed the multiple birth problem and its consequences into the background.

Web links

Individual evidence

  1. ↑ BGH, December 7, 1983 - 1 StR 665/83 Legal Information Service
  2. ↑ Sacrifice children for children . In: Focus from October 9, 2006
  3. ↑ Statement of the German Medical Association on the reduction of multiple births through fetocide ( Memento from September 19, 2010 in the Internet Archive )
  4. ↑ The silent selection . In: Die Zeit , No. 1/1999
  5. ↑ Three is one too many . In: Der Spiegel . No. 4 , 2002 ( online ).
  6. ↑ One wish, three worries . In: Die Zeit , No. 38/2002