{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:54:01Z","timestamp":1791845641482,"version":"4.3.4"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Akademie f\u00fcr Ethik in der Medizin e.V."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Sp\u00e4te Schwangerschaftsabbr\u00fcche (ab 14 Wochen p.m.) k\u00f6nnen Behandlungsteams\nvor komplexe medizinische und ethische Entscheidungen stellen. Trotz\nrechtlicher Vorgaben f\u00fcr das Vorliegen einer medizinischen Indikation bleibt\ndie konkrete Entscheidungsfindung im Einzelfall h\u00e4ufig von Unsicherheit,\nfehlender Transparenz und mangelnder struktureller Unterst\u00fctzung\ngepr\u00e4gt.<\/jats:p>\n                  <jats:p>Der Beitrag gibt Empfehlungen f\u00fcr die Erstellung klinikinterner\nEthik-Leitlinien, die eine verantwortliche, transparente und rechtlich\nabgesicherte Entscheidungsfindung im Behandlungsteam bei Wunsch nach einem\nsp\u00e4ten Schwangerschaftsabbruch unterst\u00fctzen k\u00f6nnen.<\/jats:p>\n                  <jats:p>Auf Basis vorhandener Empfehlungen und Erfahrungsberichte sowie eigener\n\u00dcberlegungen werden zentrale Herausforderungen der Entscheidungsfindung\nidentifiziert und praxisrelevante Orientierungspunkte zur Ausgestaltung des\nEntscheidungsverfahrens abgeleitet.<\/jats:p>\n                  <jats:p>Ethik-Leitlinien k\u00f6nnen Unsicherheiten reduzieren, eine interdisziplin\u00e4re,\nethisch reflektierte Entscheidungsfindung f\u00f6rdern und damit zur Verbesserung\nder Versorgung beitragen. Voraussetzung ist die Entwicklung klarer Abl\u00e4ufe,\nZust\u00e4ndigkeiten und Entscheidungsmodalit\u00e4ten sowie die F\u00f6rderung einer\ndifferenzierten Auseinandersetzung mit unterschiedlichen professionellen\nSichtweisen und pers\u00f6nlichen Werthaltungen. Die Entwicklung und\nImplementierung klinikinterner Ethik-Leitlinien kann eine relevante\nStrukturhilfe f\u00fcr Behandlungsteams bieten, um sp\u00e4te Schwangerschaftsabbr\u00fcche\nverantwortungsvoll zu begleiten.<\/jats:p>","DOI":"10.1055\/a-2843-8402","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T07:18:20Z","timestamp":1786691900000},"page":"376-386","source":"Crossref","is-referenced-by-count":0,"title":["Verantwortliche Entscheidungsfindung bei Wunsch nach sp\u00e4tem\nSchwangerschaftsabbruch. Empfehlungen zur Erstellung klinikinterner\nEthik-Leitlinien"],"prefix":"10.1055","volume":"230","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0969-3774","authenticated-orcid":false,"given":"Ruth","family":"Denkhaus","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Gesundheitsethik an der Evangelischen Akademie Loccum,\nHannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"G\u00f6bert","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr angewandte und klinische Ethik im\nGesundheitswesen, Philipps-Universit\u00e4t Marburg, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7324-9896","authenticated-orcid":false,"given":"Leonie","family":"Abstein","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Sozialethik, Universit\u00e4t Z\u00fcrich, Z\u00fcrich,\nSwitzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Reitz","sequence":"additional","affiliation":[{"name":"Frauenklinik, Elisabeth-Krankenhaus Essen GmbH, Essen,\nGermany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8239-3474","authenticated-orcid":false,"given":"Irene","family":"Hirschberg","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Ethik, Geschichte und Philosophie der\nMedizin, Medizinische Hochschule Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"ref3","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1055\/a-1893-3158","article-title":"Klinische Angebote zum Schwangerschaftsabbruch im zweiten und dritten Trimenon \u2013\neine explorative Erhebung zur aktuellen Versorgungslage","volume":"35","author":"M B\u00f6hm","year":"2022","journal-title":"Zeitschrift f\u00fcr Sexualforschung"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-025-01196-3","article-title":"Women\u2019s wellbeing as an empty declaration? A qualitative exploration of\nchallenges in accessing termination of pregnancy due to fetal anomaly in\nGermany","volume":"26","author":"T Nov-Klaiman","year":"2025","journal-title":"BMC Medical Ethics"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1186\/s12978-025-02116-9","article-title":"Structural barriers to medically indicated abortion in Germany: A qualitative\nstudy of provider perspectives","volume":"22","author":"A Kolandt","year":"2025","journal-title":"Reproductive Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1007\/s00129-023-05110-z","article-title":"Praxisorientierter Umgang mit sp\u00e4ten Schwangerschaftsabbr\u00fcchen und\nFetoziden","volume":"56","author":"A Geffroy","year":"2023","journal-title":"Die Gyn\u00e4kologie"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/s00481-024-00820-x","article-title":"Empfehlungen zur Erstellung von Ethik-Leitlinien in Einrichtungen des\nGesundheitswesens","volume":"36","author":"Vorstand der Akademie f\u00fcr Ethik in der Medizin\ne.V","year":"2024","journal-title":"Ethik in der Medizin"},{"key":"ref13","first-page":"A133","article-title":"Sp\u00e4tinterruptio und Fetozid \u2013 das Kieler Modell. Juristische und gyn\u00e4kologische\n\u00dcberlegungen","volume":"102","author":"C von Kaisenberg","year":"2005","journal-title":"Deutsches \u00c4rzteblatt"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1007\/s00194-025-00752-w","article-title":"Schwangerschaftsabbr\u00fcche nach medizinisch-sozialer Indikation. Begutachtungen am\nInstitut f\u00fcr Rechtsmedizin Frankfurt (2014-2023)","volume":"35","author":"E Stephan","year":"2025","journal-title":"Rechtsmedizin"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1007\/978-3-476-05762-4_55","volume-title":"Abtreibung \u2013 medizinethisch","author":"T Krones","year":"2020"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1186\/s12910-021-00730-3","article-title":"Ethics experts and fetal patients: a proposal for modesty","volume":"22","author":"D Schmitz","year":"2021","journal-title":"BMC Medical Ethics"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1007\/s00481-023-00762-w","article-title":"Standards f\u00fcr Ethikberatung im Gesundheitswesen","volume":"35","author":"Vorstand der Akademie f\u00fcr Ethik in der Medizin\ne.V","year":"2023","journal-title":"Ethik in der Medizin"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3390\/children11111349","article-title":"Utilization and Evaluation of Ethics Consultation Services in Neonatal Intensive\nCare","volume":"11","author":"P G\u00f6bert","year":"2024","journal-title":"Children"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-025-01207-3","article-title":"How to deal with the criterion of severe mental distress for late termination of\npregnancy? A scoping literature review and a content analysis of clinical ethics\nconsultations","volume":"26","author":"C Wetterauer","year":"2025","journal-title":"BMC Medical Ethics"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1607679","article-title":"Schwangerschaftsabbruch im zeitlichen Bereich der extrauterinen Lebensf\u00e4higkeit\n\u2013 Entscheidungsfindung im Rahmen ethischer Fallkonferenzen","author":"A von der Wense","year":"2017","journal-title":"Zeitschrift f\u00fcr Geburtshilfe und Neonatologie"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s00129-017-4170-8","article-title":"Sp\u00e4te Schwangerschaftsabbr\u00fcche bei fetalen Anomalien","volume":"51","author":"I-D Grahe","year":"2018","journal-title":"Der Gyn\u00e4kologe"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1055\/s-2005-865932","article-title":"Entscheidungsfindung bei sp\u00e4ten Schwangerschaftsabbr\u00fcchen","volume":"65","author":"T Wernstedt","year":"2005","journal-title":"Geburtshilfe und Frauenheilkunde"},{"key":"ref24","first-page":"185","volume-title":"Das Erlanger Beratungsmodell bei sp\u00e4ten Schwangerschaftsabbr\u00fcchen und seine\nEntwicklung in den Jahren 2005 und 2006","author":"U Fahr","year":"2008"},{"key":"ref25","first-page":"172","volume-title":"Entscheidungsfindung bei sp\u00e4ten Schwangerschaftsabbr\u00fcchen. Ann\u00e4herungen an gute\nVerfahrensweisen","author":"T Wernstedt","year":"2008"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1055\/s-0043-103461","article-title":"Termination of Pregnancy for Medical Indications under Sec. 218a Para. 2 of the\nGerman Criminal Code \u2013 Real-life Data from the \u201cGie\u00dfen Model\u201d","volume":"77","author":"R Dettmeyer","year":"2017","journal-title":"Geburtshilfe und Frauenheilkunde"},{"key":"ref27","volume-title":"Teil 5 Schwangerschaftsabbruch (\u00a7\u00a7 218-219b StGB)","author":"K Ulsenheimer","year":"2020"},{"key":"ref28","doi-asserted-by":"crossref","DOI":"10.17433\/978-3-17-042893-5","volume-title":"Arztstrafrecht","author":"E Kraatz","year":"2023"},{"key":"ref29","volume-title":"Pr\u00e4nataldiagnostik und psychosoziale Beratung. Aus der Praxis f\u00fcr die\nPraxis","author":"K Wassermann","year":"2009"},{"key":"ref30","doi-asserted-by":"crossref","DOI":"10.17433\/978-3-17-023886-2","volume-title":"Hrsg. Beratung schwangerer Frauen. Interprofessionelle Zusammenarbeit bei\nPr\u00e4nataldiagnostik","author":"C Wewetzer","year":"2013"},{"key":"ref31","doi-asserted-by":"crossref","DOI":"10.17433\/978-3-17-034207-1","volume-title":"Krisen in der Schwangerschaft","author":"A Dorn","year":"2020"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1055\/a-2217-9635","article-title":"Ethische Haltungen und Umgang in pr\u00e4natalen Konfliktsituationen \u2013 eine Umfrage\nunter Geburtshelfern und Pr\u00e4nataldiagnostikern in Deutschland","author":"K Schneider","year":"2024","journal-title":"Zeitschrift f\u00fcr Geburtshilfe und Neonatologie"},{"key":"ref33","first-page":"361","volume-title":"Schwangerschaftsabbruch bei zu erwartender extrauteriner Lebensf\u00e4higkeit des\nKindes","author":"G Marckmann","year":"2022"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s11017-008-9076-y","article-title":"Conscientious Refusal by Physicians and Pharmacists: Who Is Obligated to Do\nWhat, and Why?","volume":"29","author":"D W Brock","year":"2008","journal-title":"Theoretical Medicine and Bioethics"},{"key":"ref36","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511973727","volume-title":"Conscientious Objection in Health Care","author":"M R Wicclair","year":"2011"}],"container-title":["Zeitschrift f\u00fcr Geburtshilfe und Neonatologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2843-8402.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:38:49Z","timestamp":1791844729000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2843-8402"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":27,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2026,10,12]]},"published-print":{"date-parts":[[2026,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2843-8402","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0948-2393","1439-1651"],"issn-type":[{"value":"0948-2393","type":"print"},{"value":"1439-1651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]}}}