Reforming Fetal Surgery: Maternal Autonomy and Fetal Interests

Advances in fetal surgery have intensified longstanding ethical tensions between maternal autonomy and fetal interests, exposing limitations within the current UK legal framework. Despite the increasing clinical use of in utero interventions, the law provides no coherent doctrine specifically addressing fetal surgery, instead relying on fragmented principles drawn from abortion law, consent jurisprudence, and fetal personhood doctrine. This article undertakes a doctrinal and ethical analysis of the existing statutory and case law framework to assess whether it adequately mediates conflicts between pregnant women and fetal interests in surgical contexts. It argues that the current framework obscures rather than resolves these tensions by failing to articulate clear principles governing maternal refusal, fetal benefit, and state intervention. The absence of legal clarity risks inconsistent clinical practice and reinforces conceptual confusion regarding fetal rights. The article concludes that targeted legal reform is necessary to clarify the application of consent principles in fetal surgery while preserving maternal autonomy as the central organising principle. It proposes a principled framework that integrates ethical analysis without conferring independent legal personhood on the fetus, thereby providing clearer guidance for clinicians and safeguarding reproductive rights.