Documenting moral agency: a qualitative analysis of abortion decision making for fetal indications.

OBJECTIVES: We explored whether the decision-making process of women aborting a pregnancy for a fetal indication fit common medical ethical frameworks.

STUDY DESIGN: We applied three ethical frameworks (principlism, care ethics, and narrative ethics) in a secondary analysis of 30 qualitative interviews from women choosing 2nd trimester abortion for fetal indications.

RESULTS: All 30 women offered reasoning consistent with one or more ethical frameworks. Principlism themes included avoidance of personal suffering (autonomy), and sparing a child a poor quality of life and painful medical interventions (beneficence/non-maleficence). Care ethics reasoning included relational considerations of family needs and resources, and narrative ethics reasoning contextualized this experience into the patient's life story.

CONCLUSIONS: This population's universal application of commonly accepted medical ethical frameworks supports the position that patients choosing fetal indication abortions should be treated as moral decision-makers and given the same respect as patients making decisions about other medical procedures.

IMPLICATIONS: These findings suggest recent political efforts blocking abortion access should be reframed as attempts to undermine the moral decision-making of women.