Table 2 Three controversial cases

Case 1 (S6): EC was demanded during pregnancy by the parents-to-be, who were confronted with the fatal prenatal diagnosis of trisomy 18 in the 25th week of pregnancy. They wished to prepare and ethically justify, with the help of the EC, the postnatal management, i.e. comfort care without life-sustaining measurements for the neonate. They feared that without EC support, their wish might not be respected by clinicians aiming at life protection at all cost possibly using guidelines for justification [39].

Case 2 (S5, R3): The head physician requested an EC when a pregnant patient demanded a selective feticide or, if not granted, abortion of her healthy twin pregnancy resulting from fertility treatment, claiming to feel overburdened. Offering selective feticide was denied after EC discussing the conflict between the maternal interests vs. those of the unborn. But the patient underwent abortion in her home country (a “transitional” country with considerable latitude regarding legal abortion). The physician requested another EC when the patient after returning demanded treatment again which upon intense discussion was not offered.

Case 3 (R4): An EC was requested by the leading physician when a couple suggested the infertile husband’s father (and thus potential grandfather to the unborn child) should be the sperm donor. Especially the wife, who wished to reach a maximum of genetic similarity to her husband by this approach, strictly rejected any anonymous donor – the usual treatment option. After careful consideration of all options the couple’s wish was by consensus not supported in the EC. However, on further reflection the leading physician changed his decision and allowed the husband’s father to donate his sperm.