• Ethics;
  • fatal outcome;
  • prenatal diagnosis

Please cite this paper as: Wilkinson D, Thiele P, Watkins A, De Crespigny L. Fatally flawed? A review and ethical analysis of lethal congenital malformations. BJOG 2012;119:1302–1308.

Prenatally diagnosed abnormalities that are associated with death in the newborn period are often referred to as ‘lethal malformations’. Yet, for many of the commonly described lethal malformations long-term survival is possible if supportive interventions are provided. In this paper we analyse and review fetal or congenital lethal abnormalities. The designation ‘lethal’ overlaps with the concept of ‘medical futility’. The term is used for a heterogenous group of conditions, and hinders clear communication and counselling. We argue that the term should be avoided, and propose in its place a set of key questions that should be addressed by counselling.