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Re: Informed Refusal - VBAC From: l.glazerman@rcn.com Wed Mar 15 16:53:00 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Jamie: "Re: Informed Refusal - VBAC" Previous message: Jamie: "Re: Informed Refusal - VBAC" Maybe in reply to: Dr. Ainsworth: "Informed Refusal - VBAC" Next in thread: Jamie: "Re: Informed Refusal - VBAC" Reply: Jamie: "Re: Informed Refusal - VBAC" Call my lawyer? That was obviously tongue in cheek, but it's a tough one. It's somewhat similar to the patient who comes to the labor room actively laboring, and hasn't signed consent for labor and deliveyr (which my hospital, for some inane reason, requires). that begs the question that you can only consent to that which you are capable of refusing. >---- Original message ---- >Date: Wed, 15 Mar 2006 17:37:42 -0600 >From: ajfields@pine-net.com (Jamie) >Subject: Re: Informed Refusal - VBAC >To: Multiple recipients of list OB-GYN-L <ob-gyn- l@dns.obgyn.net> > >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: Jamie: "Re: Informed Refusal - VBAC" Previous message: Jamie: "Re: Informed Refusal - VBAC" Maybe in reply to: Dr. Ainsworth: "Informed Refusal - VBAC" Next in thread: Jamie: "Re: Informed Refusal - VBAC" Reply: Jamie: "Re: Informed Refusal - VBAC"

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