Re: Risks / Benefits of Cesarean -- NEJM
From: Joe (forcep@intercom.net)
Fri Mar 2 20:52:30 2007
Certainly would severly limit lawsuits in USA. Joe C
Bernard Cristalli wrote:
> We're heading to a 100% C/S rate.
>
> BC
> Even Chuck Norris will melt in front of a french baguette
>
> DoctorJoe@aol.com a écrit :
>
>>
>> In a message dated 3/1/07 3:36:44 PM, dean@thehuffpeople.net writes:
>>
>>> Interesting article in today's NEJM about risk/benefits of cesarean.
>>>
>>> http://content.nejm.org/content/vol356/issue9/index.shtml
>>
>> And I like the ending. It's the WOMEN who choose to take the risk, for
>> possible benefit for the baby.
>>
>> "But the key question centers on both the number needed to treat to
>> avoid one adverse neonatal outcome and the level of risk that is
>> currently considered acceptable. As practicing obstetricians, we find
>> that the risk that women are now willing to assume in exchange for a
>> measure of potential benefit, especially for the neonate, has changed:
>> for many, the level of risk of an adverse outcome that was tolerated
>> in the past to avoid cesarean delivery is no longer acceptable, and
>> the threshold number needed to treat has thus been reset.
>>
>> In the face of the resulting continued increase in cesarean
>> deliveries, our obligation as providers is to educate patients about
>> the trade-offs entailed in choosing a particular course or
>> intervention and to ensure that their choices are congruent with their
>> own philosophy, plans, and tolerance of risk. In areas in which there
>> is still uncertainty, we must organize clinical trials that will
>> produce the data we require for counseling patients. For the moment,
>> however, few of the relevant factors seem likely to change, and the
>> cesarean rate can be predicted to continue its climb."
>>
>> Of course, if we're harassed by 3rd party insurers, busy-body
>> regulators and societies, and the like, if WE shy away from a
>> C-section, it's ultimately the WOMAN who doesn't get her wish granted.
>> So regulation of the doctor is an indirect way to coerce the woman to
>> take what she perceives as more risk for her baby. Talk about insidious.
>>
>> Joe P.
>>
>> "There are only two things that can cut diamonds: other diamonds, and
>> Chuck Norris."
>>
>
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