Ethics plays an essential role in the clinical management of pregnancies complicated by fetal anomalies diagnosed by ultrasound. Utilizing the prima facie ethical principles of beneficence and respect for autonomy; this paper first explicates the ethical concept of the fetus as a patient. This ethical concept provides the basis for a comprehensive approach to counseling pregnant women about the management of pregnancies complicated by fetal anomalies. Practical; ethically justified guidance is given for counseling about decisions both before and after viabilities