The Intersection of Medicine, Law, and Ethics: Fetal Personhood Laws and the Erosion of Autonomy in Medical Decision-Making and End-of-Life Care

Abstract: The concept of fetal personhood is deeply polarizing, influenced by medicine, philosophy, law, religion, ethics, and politics. While reproductive autonomy was a central issue in the 2024 election, it has not been the focus of recent federal Executive Orders or administrative actions. However, various state legislatures have introduced bills recognizing fetal personhood. Such laws erode a pregnant individual’s right to autonomous medical decision-making and grant states increased authority over a pregnant individual’s medical decisions, from conception through end-of-life care. The laws have profound ethical, medical, and legal implications.
Fetal personhood is implied in civil wrongful death statutes which have been used to justify punitive actions against pregnant individuals. Expanding existing fetal endangerment or fetal protection laws, or enacting fetal personhood laws increases the state’s power to criminalize behavior during pregnancy. These laws will restrict an individual’s rights by allowing states to control medical decisions when the patient is pregnant
Enacting fetal personhood laws and expanding fetal endangerment laws will diminish the right to refuse medical intervention and dismiss the goals, values, and preferences established through advance care plans. Such laws could lead to the enactment of new advance directive pregnancy exclusions and expand existing laws overriding an advance directive and the decision to withhold or withdraw life-prolonging care.
This presentation examines the intersection of fetal personhood and fetal endangerment laws, abortion bans, and the impact on advance directives. It highlights the broader consequences for medical decision-making and underscores the necessity of collaborative discourse in addressing these pressing bioethical challenges.

Keywords: “fetal personhood”, “Pregnanacy and medical decision-making”, “Advance directive-pregnancy exclusions”