AS RECENTLY stated by the ethics committee of the American College of Obstetricians and Gynecologists, the maternal-fetal relationship is a "unique one" as it involves "two patients with access to one through the other."¹In no other situation is the physician faced with one patient literally inside the body of another patient. Conceptually, the medical care of each can be approached independently, but practically, neither can be treated without affecting the other. Because of this unique relationship, conflicts between the interests of the woman and the fetus can arise if the former refuses treatment recommended for the benefit of the latter (eg, refusing cesarean section for documented fetal distress and anoxia) or if she is unwilling or unable to change behaviors that potentially could harm her fetus, such as smoking, consuming alcohol, eating inadequately, or engaging in certain job-related or recreational activities. Kolder et al²recently documented a
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Lawrence J. Nelson (1988) studied this question.