Prima Facie Principle in Resolving the Ethical Dilemma of Twisted Ovarian Cyst Cases in Pregnant Women 7-8 Weeks with a History of Primary Infertility

Background: Resolving the ethical dilemma in a case of 7-8 weeks pregnant women with a history of primary infertility with twisted ovarian cysts. Method: A case report. Finding: a 25-year-old patient, presents with severe right lower abdominal pain due to a twisted cyst in the right ovary. The patient is also currently 7-8 weeks pregnant with an intra uterine pregnancy with a history of primary infertility. The ethical dilemma that arises in this case is lifting the ovary (oophorectomy) with the risk of reducing the chances of subsequent pregnancy or maintains the ovary with cysts with the risk of infection and severe pain. For this reason, an analysis of solving ethical dilemmas is carried out by using the prima facie principle. By prioritizing the principle of non-maleficence over autonomy, patients are encouraged to undergo exploratory laparotomy operations to oophorectomy (removal of the ovaries) by maintaining a 7 - 8 week pregnancy. Conclusion: The prima facie principle guides clinicians to respect the patient’s autonomy but must not make the patient worse. By using the prima facie principle, the patient’s medical problems can be resolved while still prioritizing the values of medical ethics.