«Fetus as a patient»: ethical aspects of fetal surgery; «Плод как пациент»: этические аспекты фетальной хирургии

More than six decades have passed since the first documented intrauterine intervention. Fetal surgery has transformed from an experimental procedure into everyday clinical practice over the years. Despite the significant potential for today, maternal and fetal surgery can be classified as complex medical interventions, which cause certain ethical problems. Ethical principles in fetal surgery are established through an analysis of the ratio of potential benefits and possible risks to the health of a woman and an unborn child. One of the central issues remains determining the moral status of the fetus, whose legal and biological status is directly related to the rights and interests of the mother. The present work is devoted to the analysis of ethical problems arising in the practice of fetal surgery. Objective. Considering various approaches to determining the moral status of the fetus as an object of medical care and a part of the mother's body. Analysis of the balance of potential risks and benefits for the pregnant woman and fetus during surgery. Material and methods. A comparative analysis of research in the field of philosophy and bioethics was conducted, also as regulatory documents devoted to the problem of the moral and legal status of the fetus. The doctrine of the double effect is considered as a methodological tool for the ethical assessment of intrauterine surgical interventions. © 2025 Elsevier B.V., All rights reserved.