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Hippocrates has long been celebrated as the Father of Medicine, yet many may not know that he first proposed the then-revolutionary idea of preventive medicine. In Aphorisms, he writes, “Extreme remedies are very appropriate for extreme diseases.” Although he many not have envisioned fetal surgery at the time, these eight words continue to affect surgeons today. Fetal surgery is the treatment of disease and correction of deformity or defect by manual and operative procedures on the fetus as it remains in the mother’s uterus. Though a few doctors experimented with fetal surgery in the 1960s, it was not until the early 1980s that, after numerous trials in animals, Dr. Michael Harrison, director of the fetal treatment center at UCSF, began operating on fetuses with life-threatening tumors. Harrison was the fist physician in the world to perform a successful repair surgery on a living human fetus. The first fetal patient suffered from an enlarged bladder that would prevent the normal maturation of the lungs, eventually leading to death soon after birth. By the mid-1990’s, Dr. Bruner at Vanderbilt University decided it was time to try surgery on fetuses with non-lethal malformations; his first prenatal patient suffered from spina bifida. Though a lot of attention has been paid to the repair of this type of anomaly, surgery is also performed on fetuses with hydrocephalus and diaphragmatic hernia. The goal is not so much to save lives anymore, but to improve the quality of the life for the fetus. By repairing defects early, doctors are able to prevent further damage to the fetus. Not only does fetal surgery raise a number of medical ethical issues, it also gives rise to controversy surrounding issues such as fetal rights and reproductive politics.
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