Doctor's Duty When Diagnosing Fetal Abnormalities: The Complete Legal Guide

May 27, 2026

When a doctor diagnoses (or should have diagnosed) a fetal abnormality, they find themselves at a critical legal moment. What the doctor says, explains, or fails to explain can determine whether a "wrongful life" claim is filed — formerly known as "wrongful birth" — or not.

Many doctors do not fully understand their obligations in such a situation — and this leads to negligence, lawsuits, and trauma for families.

In this article we detail exactly what the doctor's duties are when diagnosing fetal abnormalities:

Duty of disclosure
Duty of explanation
Duty to inform about options
Duty of referral
What doctors must not do
Case law examples

Duty of Disclosure

The principle: A doctor must disclose to the patient all relevant information that could affect their decisions.

In the case of a fetal abnormality: The doctor must disclose the existence of the abnormality — without delay.

Prohibited:

Concealing the information
Postponing ("We'll tell you next time")
Downplaying its significance

Even if the doctor believes the parents would not want to terminate the pregnancy — they are still obligated to provide the information!

The principle: A patient is entitled to make an informed decision regarding their medical treatment — only after receiving all relevant information. This is also mandated by the Patient Rights Law.

In the case of a fetal abnormality: Parents are entitled to decide whether to continue the pregnancy — only after receiving all information about:

What the abnormality is
What the prognosis is
What the options are
What the risks are

If the doctor did not provide complete information — the parents could not make an informed decision — and this constitutes medical malpractice!

Duty of Disclosure - What Must the Doctor Disclose?

1. Disclosing the Existence of the Abnormality - Immediately!

The moment the doctor identifies (or suspects) an abnormality:

Must inform the parents
Immediately (no postponement!)
Clearly

Example of negligence: A doctor sees in an ultrasound (week 20) a suspected serious cardiac defect. He says: "Everything looks fine, come back in a month." Instead — he should have said immediately: "There is a suspected heart defect, further tests are needed."

Why is this negligent? Delayed disclosure = delayed diagnosis = delayed ability to terminate the pregnancy (if parents would have wished to).

2. Disclosing the Type of Abnormality - In Clear Language

The doctor must explain:

What the abnormality is — using its medical name plus a simple explanation
Where the abnormality is located (heart, brain, spine, etc.)
How severe it is

Good example: "In the ultrasound we found a heart defect — called VSD (a hole between the heart chambers). This is a moderate defect — the child will need surgery in infancy, but most children live normal lives after the operation."

Bad example (negligence): "There is some problem with the heart, but it's fine."

3. Disclosing the Prognosis - What Is Expected?

The doctor must explain:

Will the child survive? (yes / no / depends)
What will quality of life be? (Will there be intellectual disability? Will the child be able to walk, speak, learn? Will constant assistance be needed?)
What treatments will be required? (Surgeries, medications, rehabilitation?)
What are the risks? (Death, disability?)

Important: The doctor cannot know with certainty what will happen in every case — but they are obligated to provide the best estimate based on medical knowledge, or refer parents to consult with pediatric specialists who treat children with such conditions.

Good example for Down syndrome: "Your child has Down syndrome. This means they will have intellectual disability — usually mild to moderate (most children with Down syndrome learn to speak, read, and write — but at a slower pace); heart problems — approximately 50% of children with Down syndrome are born with a heart defect; life expectancy — today most people with Down syndrome live into their 60s-70s; and independence — some live independently or with minimal support, others require more significant assistance."

4. Disclosing Options - Continue or Terminate

The doctor must explain that there are two options:

A. To continue the pregnancy:

What will happen after birth?
What treatments will be available?
What support exists (national insurance, organizations, support groups)?

B. To terminate the pregnancy:

Is this legally possible?
What is the process? (Committee, the termination itself)
What are the medical risks?
What are the psychological implications?

Important: The doctor must present both options — even if they personally believe one is preferable!

Example of negligence: A doctor who says: "There is a serious defect, you have no choice, you must terminate the pregnancy." The doctor is forcing a decision, not providing a genuine choice, and violating patient rights.

5. Disclosing Rights - What Parents Are Entitled To

The doctor must explain:

Right to time to think
Right to a second opinion
Right to psychological support
Right to apply to a pregnancy termination committee (if relevant)

Duty of Explanation - How to Explain?

1. In Simple, Understandable Language

The doctor cannot rely solely on medical terminology!

Bad example: "Your fetus has Holoprosencephaly."

Good example: "Your fetus has Holoprosencephaly — this is a serious brain defect in which the brain does not develop properly. The child will not survive — most babies with this condition die within days or weeks after birth."

2. In Measured Doses - Do Not Overwhelm

Parents should not be overwhelmed with all the information at once. Recommended process:

Initial explanation — what the defect is, how serious (briefly)
Allow parents to process — a few minutes, or even return the next day
Detailed explanation — prognosis, options, processes
Answer questions

3. Verify Understanding

After the explanation, the doctor should ask: "Tell me in your own words — what did you understand?" and "Is there anything that's not clear?" — because sometimes parents think they understood, but in practice did not.

4. Allow Opportunity for Questions

The doctor must give parents the opportunity to ask questions and answer them patiently and clearly.

5. Document Everything

The doctor must document in the medical record: what was explained, when it was explained, whether the parents understood, what questions were asked, and the answers. If not documented — the court will assume it was not explained.

Duty of Referral - To Whom Must the Doctor Refer?

1. Referral to a Medical Specialist

If an abnormality is suspected — the doctor must refer to a specialist:

Suspected cardiac defect → pediatric cardiologist (fetal echocardiography)
Suspected brain defect → neurologist (fetal MRI)
Suspected genetic defect → geneticist

A general practitioner or family doctor cannot "manage alone"!

2. Referral for Genetic Counseling

If the defect is genetic or chromosomal — referral to a genetic counselor. What the genetic counselor does:

Explains the defect from a genetic perspective
What the risk is in future pregnancies
Whether there is risk to family members
What additional tests are relevant

3. Referral for Psychological Support

This is the duty most doctors forget! Diagnosis of an abnormality = emotional trauma. The doctor must offer a meeting with a psychologist or social worker. Some parents will decline — that is fine. But the doctor must offer!

4. Referral to a Pregnancy Termination Committee

If the defect warrants pregnancy termination — the doctor must offer referral to the committee. The doctor does not need to decide whether parents want to terminate, but must present the option.

Example of negligence: A doctor diagnoses Edwards syndrome (a lethal chromosomal defect). He does not offer referral to the committee because he assumes the parents are religious and "surely won't want to terminate." This is negligence: the doctor cannot decide on behalf of the parents — they might indeed have wanted to terminate.

5. Referral to Support Organizations

It is advisable (though not a strict legal obligation) to refer parents to organizations that support parents of children with disabilities, support groups, and forums.

What Must the Doctor Not Do?

Must Not: Conceal Information

Even if the doctor believes parents do not need to know — they must tell them!

Example: A doctor finds a soft marker for Down syndrome in an ultrasound. He thinks: "It's just a marker, no certainty, why worry them?" and says nothing. Why is this negligent? Parents are entitled to know all relevant information — they can decide whether to pursue amniocentesis to confirm or rule out the diagnosis. Concealing information = violation of the right to informed consent.

Must Not: Force a Decision

The doctor cannot say: "You must terminate the pregnancy" / "You cannot terminate" / "This is what any normal woman would do." The decision belongs to the parents — and to them alone!

Must Not: Downplay the Severity of the Abnormality

Example: A doctor finds severe spina bifida and says: "There is a minor problem with the back, but most children are fine." Severe spina bifida = lifelong serious disability (paralysis, loss of bladder and bowel control). The doctor is misrepresenting the picture, preventing informed decision-making.

Must Not: Cause Undue Fear

In the opposite direction: Example: A doctor finds a cleft lip and says: "Your child will suffer from this defect their entire life." A cleft lip can be surgically corrected, and most children live completely normal lives after repair.

Must Not: Delay Disclosure

If there is an abnormality — it must be disclosed immediately! Prohibited: "We'll discuss this next time" / "No need to worry now" / "Come back in a month and we'll see." Delay = negligence!

Must Not: Abandon the Patient

After the doctor has communicated the information about the abnormality — they cannot "disappear"! The doctor must remain available for questions, update on test results, and accompany the parents through the process. If the doctor "disappears" — this constitutes patient abandonment, and is medical malpractice.

Special Duties in Specific Contexts

When Parents Are Religious

Some doctors think: "They're religious, they won't terminate a pregnancy, so why offer?" This is a mistake! Religious parents are also entitled to receive all information and decide for themselves. Sometimes even religious parents do terminate pregnancies (in cases of lethal defects). The doctor cannot assume they know what the parents will want!

When Parents Do Not Speak the Local Language

The doctor must ensure parents understand:

Bring a translator
Do not rely on a family member to translate (potential conflict of interest)
Provide written explanatory materials in their language

When Parents Have Intellectual Disabilities

The doctor must adapt the explanation to their level of understanding. Sometimes a guardian is needed to assist with decision-making.

When Parents Disagree with Each Other

If the mother wants to terminate and the father does not (or vice versa) — the woman is the one who decides (it is her body, her pregnancy). However, the doctor should encourage dialogue between the couple, and sometimes refer for couples counseling.

Case Law Examples

Case 1: Doctor Failed to Explain the Prognosis Correctly

Facts: In an ultrasound (week 22) a serious cardiac defect was found (Hypoplastic Left Heart Syndrome — underdeveloped left ventricle). The doctor said: "There is a heart problem, but it can be fixed with surgery, the child will be fine." The woman continued the pregnancy. A baby was born who underwent 3 cardiac surgeries in the first year, lived with chronic heart failure and significant disability, and died at age 5.

Claim: The doctor failed to properly explain the severity of the defect. Had he explained that the child would require numerous surgeries, would live with disability, and might die — the parents would have terminated the pregnancy.

Ruling: The court accepted the claim — the doctor minimized the severity of the defect, did not explain the true prognosis, and the parents did not receive informed consent. Damages were awarded.

Case 2: Doctor Pressured the Woman to Terminate

Facts: Down syndrome was detected. The doctor said: "You must terminate the pregnancy immediately. A child with Down syndrome is a catastrophe. No one wants such a child." The woman, under pressure, terminated the pregnancy — and later deeply regretted it.

Ruling: The court accepted the claim — the doctor did not provide a genuine choice, used offensive and demeaning language, and violated the duty of neutral explanation.

Case 3: Doctor Failed to Refer to the Committee

Facts: In an ultrasound (week 23) a serious brain defect was found (Holoprosencephaly). The woman asked: "Is it possible to terminate?" The doctor replied: "No, it's too late, you cannot terminate in week 23." The woman was forced to continue. The baby was born and died within 3 days.

Ruling: The court accepted the claim — the doctor was wrong (there is no legal time limit), did not refer to the committee, and deprived the woman of her right.

Case 4: Doctor Failed to Explain About NIPT

Facts: A 38-year-old woman, combined screening showed a high risk of Down syndrome (1:80). The doctor recommended amniocentesis but did not explain that NIPT exists (a simple blood test, with no risk). The woman underwent amniocentesis — and as a result miscarried (0.3% risk — and it occurred).

Ruling: The court accepted the claim — the doctor is obligated to present all available options, even those not covered by health insurance. Had the doctor presented NIPT — the woman would have chosen it and would not have miscarried.

Summary - The Doctor's Checklist of Duties

The Doctor Must:

A. Disclosure

Immediately disclose the existence of an abnormality (without delay)
Explain what the abnormality is (in clear language)
Explain how severe the abnormality is
Explain the prognosis (what is expected for the child)

B. Presenting Options 5. Present both options: continuing or terminating 6. Explain the advantages and disadvantages of each option 7. Explain the process (for each option) 8. Explain the parents' rights

C. Referrals 9. Refer to a medical specialist (to confirm/clarify the abnormality) 10. Refer for genetic counseling (if relevant) 11. Refer for psychological support 12. Refer to a pregnancy termination committee (if relevant)

D. Proper Process 13. Allow time to think 14. Answer questions 15. Verify understanding 16. Document everything in the medical record

The Doctor Must Not:

Conceal information
Force a decision
Downplay or exaggerate the severity of the abnormality
Use offensive language
Delay disclosure
Abandon the patient / discontinue contact

Tips for Doctors

1. Document, document, document! — This is the most important tool for legal protection. In the medical record — document what you explained, when you explained it, whether the patient understood, what questions were asked and the answers, and where you referred. If not documented — it did not happen (from the court's perspective).

2. Use plain language — Do not rely solely on medical terminology. Speak in language the patient will understand.

3. Be neutral — Do not force a decision. Your role = to provide information. The parents will decide.

4. Do not make assumptions — Do not assume you know what the parents will want. Religious? Perhaps they will still terminate. Secular? Perhaps they will still continue. Present all options.

5. Refer for psychological support — Always! This is the duty most doctors forget.

6. When in doubt — consult — If you are not sure what to do, what to say, or whether to refer — consult with a colleague, specialist, or legal advisor.

Summary - Key Points

Duty of disclosure — Tell everything, immediately, clearly
Duty of explanation — In plain language, detailed, patiently
Duty to inform about options — Both continuation and termination
Duty of referral — To a specialist, genetic counseling, psychologist, committee
Must not force a decision — Parents decide
Must not conceal, downplay, or cause undue fear
Duty to document — Document everything!

The golden rule: complete information + neutrality + respect for the right to choose.

If the doctor fulfills their duties — there is no medical malpractice. If the doctor does not — there is a claim. If you believe a doctor failed in their duties toward you, contact us for consultation with a specialist attorney.

This article provides general information only and does not constitute legal or medical advice.

Doctor's Duty When Diagnosing Fetal Abnormalities: The Complete Legal Guide