{"paper_id":"479caf7d-27c2-4e61-86c4-4eafc7129509","body_text":"Abstract\nThis article examines gynecological decision-making in clinical contexts where interventions carry significant implications for fertility and future reproductive possibilities. Conditions such as uterine fibroids, endometriosis, and ovarian cysts are commonly managed through treatments that differ in their potential impact on reproductive capacity, introducing an ethical dimension beyond immediate symptom management. This proposes a theological-bioethical framework of clinical discernment as a conceptual supplement to shared decision-making in reproductive healthcare. Drawing primarily on Karol Wojtyla’s personalist philosophy, it advances an account of the human person as an irreducible moral subject whose embodied life carries existential and relational significance. Clinical discernment is understood as a structured ethical orientation that enhances standard biomedical reasoning by integrating attention to value-laden dimensions of fertility-related care. The framework articulates hope as an ethically relevant category referring to the openness of the patient’s future possibilities, and fertility as a dimension of embodied personhood with relational meaning beyond biological function. On this basis, the article outlines a fertility-sensitive approach to gynecological care emphasizing proportionality in intervention, clarity and responsibility in risk communication, and holistic patient accompaniment. 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The author has no funding to declare.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nCompeting interests\nThe author has no competing interests, financial or non-financial, to declare.\nEthical approval\nThis study does not involve any human participants, animals, or sensitive data requiring ethical approval. Therefore, ethical review and approval were not applicable.\nAdditional information\nPublisher’s Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nNuqui, J.M.F.M., Duarte, K.L. Hope, fertility, and the ethics of clinical discernment: a personalist supplement to ethical decision-making in gynecological practice. Med Health Care and Philos (2026). https://doi.org/10.1007/s11019-026-10379-7\nReceived:\nAccepted:\nPublished:\nVersion of record:\nDOI: https://doi.org/10.1007/s11019-026-10379-7","source_license":"public-domain-us","license_restricted":false}