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Re: Informed Refusal - VBAC From: Jamie (ajfields@pine-net.com) Wed Mar 15 16:37:32 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: l.glazerman@rcn.com: "Re: Informed Refusal - VBAC" Previous message: zygote@icsi.net: "Re: Informed Refusal - VBAC" In reply to: Efrain Ramirez: "Re: Informed Refusal - VBAC" Next in thread: Dr Eberhard Lisse: "Re: Informed Refusal - VBAC" Reply: Dr Eberhard Lisse: "Re: Informed Refusal - VBAC" But you can't do c/s without consent. If the woman comes in actively laboring and refuses c/s, what do you do? At Wed, 15 Mar 2006, Efrain Ramirez wrote: > >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 > -- JFields, RN, BSN Next message: l.glazerman@rcn.com: "Re: Informed Refusal - VBAC" Previous message: zygote@icsi.net: "Re: Informed Refusal - VBAC" In reply to: Efrain Ramirez: "Re: Informed Refusal - VBAC" Next in thread: Dr Eberhard Lisse: "Re: Informed Refusal - VBAC" Reply: Dr Eberhard Lisse: "Re: Informed Refusal - VBAC"

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