Three ethically justified indications for selective termination in multifetal pregnancy: a practical and comprehensive management strategy.

The authors provide an ethical justification for three indications for performing selective termination of multi-fetal pregnancies. These indications are (1) achieving a pregnancy that results in a live birth or one or more infants with minimal neonatal morbidity and mortality, (2) achieving a pregnancy that results in a live birth of one or more infants without antenatally detected anomalies, and (3) achieving a pregnancy that results in a singleton live birth. This ethical justification is based on two basic approaches to obstetric ethics that emphasize that these indications must be established on the basis of informed consent. The authors underscore the importance of matters of private conscience and demonstrate the consistency of ethical justification with existing public policy in the United States.