Re: Elective Induction - something goes wrong
From: David Priver, MD (dpriver@aol.com)
Sun Jul 11 18:16:18 2004
To get back to the issue of elective induction, I was intrigued by
someone's remark in this long thread that patients have become so
insistent upon electively ending a pregnancy for these social and
convenience reasons that they will actually change their caregiver if
their current one won't go along. Therein lies a good part of the
problem: we are so easily intimidated by this threat that many are
prepared to abandon what they know in their heart is good medicine so as
not to lose a patient. Can anyone imagine accepting a late transfer OB
case on this basis? Would anyone really accept a patient at term under
the condition that you agree to induce her for these entirely specious
reasons? I certainly wouldn't and I'd have no respect for someone that
would.
Also, the literature is entirely clear that induced labor in a nullip
carries a dramatically higher CS rate, so why should anyone want to do
that? It would be nice to think that we as a profession could summon up
the fortitude to adhere to sound practice and refuse to induce (or
section, for that matter) a patient just because she wants it. Aren't
our liability premiums high enough?
At Sun, 11 Jul 2004, Braun, R. Daniel wrote:
>
>If it is indicated it doesn't cause pain???????????????
>Pain is harm,
>An incision is harm.
>
>"Sound is like water. If you drill one hole in the wall the sound will
>leak right through."
>
>- JAY BRAUN, a band member by love, a soundproofer by necessity.
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain
>Ramirez
>Sent: Sunday, July 11, 2004 3:34 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Elective Induction - something goes wrong
>
>I see no "harm" in doing an indicated hysterectomy - maybe we are saying
>the same thing - differenttly.
>
>>At Sun, 11 Jul 2004, Braun, R. Daniel wrote:
>>
>>And a total lack of doing anything. Starting an IV is harmful. Doing a
>>hysterectomy is harmful.
>>
>>The principle should state: Do the least harm possible while doing the
>>most good.
>>
>>Dan
>>
>>"Sound is like water. If you drill one hole in the wall the sound will
>>leak right through."
>>
>>- JAY BRAUN, a band member by love, a soundproofer by necessity.
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>Efrain Ramirez
>>Sent: Friday, July 09, 2004 7:56 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: Elective Induction - something goes wrong
>>
>>My favorite has been - "Primum non nocere" - whoever wrote it -
>>cheers..
>>
>>It is very difficult to follow that principle - it takes guts, honesty,
>
>>intelligence and a true sense of caring for people..
>>
>>>>At Fri, 9 Jul 2004, Myer Bornstein wrote:
>>>
>>>Another quote about medicine that I remember by Sydenham (of
>>>Sydenham's
>>>Chorea) :" ours is an art that is best learned by its practice and
>its
>>
>>>use."
>>>
>>>--
>>>Myer S. Bornstein, MD, MMM, FACOG, FACPE
>>>
>>> _____
>>>
>>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>>DoctorJoe@aol.com
>>>Sent: Friday, July 09, 2004 8:42 AM
>>>To: Multiple recipients of list OB-GYN-L
>>>Subject: Re: Elective Induction - something goes wrong
>>>
>>>In a message dated 7/8/04 18:22:48, RModugno@aol.com writes:
>>>
>>>The good news is that she pushed 3 times and baby came out with Apgars
>
>>>of 9/9. Whew! I can relax again.
>>>
>>>Glen
>>>
>>>Exactly! Good for you!
>>>
>>>Just yesterday, a law professor asked me "Medicine's a science, isn't
>>>it?"
>>>
>>>My reply was "Medicine is the artful application of science."
>>>
>>>I think this is evidence of that.
>>>
>>>Joe P.
>>>
>>--
>>"The opposite of a correct statement is a false statement.
>>But the opposite of a profound truth may well be another profound
>>truth."
>>
>>Niels Bohr (1885 - 1962)
>>
>--
>"The opposite of a correct statement is a false statement.
>But the opposite of a profound truth may well be another profound
>truth."
>
>Niels Bohr (1885 - 1962)
>
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