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Re: vbac on demandFrom: Charles Bloom (cdsb@bellsouth.net)Tue May 13 05:59:25 2008
I agree with the below. All you can do is document, document, and document. You offered her a C-Section because that is what you do. She declined. She wants NATURAL childbirth so you do not intervene with any meds, you only observe. You document the risks of expectant management. The hospital's Risk Management documents their conversation. The Nursing Supervisor documents their conversation. As time goes by, you continue to offer her C-Section and document her refusal and her understanding of the risks. Eventually, she will either agree to have C-Section, deliver vaginally, or there will be a catastrophe that you warned the patient about requiring you to act emergently. And yes, during the active phase, you are stuck in the hospital with her. I would have the OR set up and ready with anesthesia in-house. Similar situations have occurred to all of us throughout our career. What do you do if the fetal heart rate is 60 and the patient refuses Cesarean? I repeat again, all you can do is document, document, and document. Charles -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr Eberhard Lisse Sent: Tuesday, May 13, 2008 5:57 AM To: Multiple recipients of list OB-GYN-L Subject: Re: vbac on demand Ah,from the statue: A hospital is deemed to meet the requirement of paragraph (1)(A) with respect to an individual if the hospital offers the individual the further medical examination and treatment described in that paragraph and informs the individual (or a person acting on the individual's behalf) of the risks and benefits to the individual of such examination and treatment, but the individual (or a person acting on the individual's behalf) refuses to consent to the examination and treatment. The hospital shall take all reasonable steps to secure the individual's (or person's) written informed consent to refuse such examination and treatment. Get the Justice of the Peace and the Politburo to witness and go home. Also the regulations seem to say that a specialized hospital can not refuse a transfer :-)-O greetings, el
on 5/13/08 10:32 AM Dr Eberhard Lisse said the following:
> Garry,
-- Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar) el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell) PO Box 8421 \ / Please do NOT email to this address Bachbrecht, Namibia ;____/ if it is DNS related in ANY way
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