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Re: Informed Refusal - VBAC From: ainsron (ainsron@sbcglobal.net) Wed Mar 15 14:17:56 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: RModugno@aol.com: "Re: Informed Refusal - VBAC" Previous message: Efrain Ramirez: "Re: Informed Refusal - VBAC" In reply to: Efrain Ramirez: "Re: Informed Refusal - VBAC" Next in thread: Jamie: "Re: Informed Refusal - VBAC" I think we do also. I'll pose the question on ACOG.net. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain Ramirez Sent: Wednesday, March 15, 2006 12:42 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Informed Refusal - VBAC At Wed, 15 Mar 2006, Dr. Ainsworth wrote: >The above is from the recent ACOG Committee Opinion on Informed Refusal. >How does that relate to our discussion on the availability of VBAC in a >small hospital? If we tell the patient that we do not have the >recommended capability for immediate availability ... yada...yada, and >they signed an informed refusal for repeat cesarean section, how >effectively would that protect us from the lawyers in case of a bad >outcome? I know many of you would say, if the patient refuses a C/S, >discharge her from your practice and send her somewhere else. However, >in rural locales, there are no suitable alternatives and "St. Elsewhere" >is over an hour and a half away. I also don't think patient refusal of >recommended care is always a reason to discharge a patient. We >sometimes have to agree to disagree. Ron... I strongly believe that if you do not have the facilities to comply with the strict standards set by our College - you cannot offer VBAC - period - it does not matter if the next suitable alternative is across the street or in the moon - if there is a bad outcome everyone will get sued and most probably evryone will have to pay... You know what I would like to see? - a written opinion - from the College - addressing this specific issue - but I doubt very much it will.. Good luck.. Ef -- " The greatest obstacle to knowledge is not ignorance, it is the illusion of knowledge." Daniel J. Boorstin - Historian Next message: RModugno@aol.com: "Re: Informed Refusal - VBAC" Previous message: Efrain Ramirez: "Re: Informed Refusal - VBAC" In reply to: Efrain Ramirez: "Re: Informed Refusal - VBAC" Next in thread: Jamie: "Re: Informed Refusal - VBAC"

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