Re: vbac on demand
From: R. Daniel Braun (rd.braun@gmail.com)
Sun May 25 19:30:15 2008
That is one of only a few bad things about the USA. Most everything else is
good. Like today, I sat on my deck and listened to the race and hefted a
few. Then cooked ribs and enjoyed them.
Dan
On Sun, May 25, 2008 at 7:29 PM, Raymond Stephen <
Stephen.Raymond@dhhs.tas.gov.au> wrote:
> No flame – it appears that the world of litigation in the States is so
> far removed from that in other countries that what I said doesn't apply.
> Thank God, I don't live in Uncle Sam's paradise!
>
> Steve
>
> Steve Raymond FRANZCOG FRCOG
> HOD Obstetrics & Gynaecology
> Royal Hobart Hospital
> Tasmania 7001
> ------------------------------
>
> ------------------------------
> *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of *Hen=
> ------------------------------
ry
> Gregor
> *Sent:* Monday, 26 May 2008 1:22 AM
> *To:* Multiple recipients of list OB-GYN-L
> *Subject:* RE: vbac on demand
>
> Wow, Steve, your post shook me loose from my prior resolve not to comment
> on this potentially never ending discussion. But your conjecture that a bad
> outcome will not lead to litigation in the event of a bad outcome if what
> the patient desired got done...whew!!...that just flies totally in the face
> of a mountain of factual litigation history re lawsuits over adverse VBAC
> outcomes. Those suits go to trial despite informed consent processes having
> been observed....(I'll conjecture at this point that cases done without
> documentation of informed consent get settled before trial...will further
> conjecture that it would be difficult to find VBAC's being done in today's
> USA medical-legal climate without informed consent.) So, your sanguine view
> that doing what the patient wants will insulate one from litigation seems a
> bit misguided, IMHO, no flame intended, whatsoever.
>
> Hank
> *Raymond Stephen <Stephen.Raymond@dhhs.tas.gov.au>* wrote:
>
> All of the concern about losing one's career and livelihood really applies
> in a different way when you are faced with a patient who doesn't want to
> accept your blanket policies. Is she more likely to sue you and win, if you
> do what she wants and she has a bad outcome, or is it more likely, if you
> don't do what she wants and has a different bad (to her) outcome. I would
> have thought that, given that most litigation arises out of a situation
> where a patient's expectations haven't been met, it is likely that the bad
> outcome that you predicted will not lead to litigation, if you do what she
> wants.
>
> Steve
>
> ------------------------------
>
> ------------------------------
> *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of *
> ------------------------------
> DoctorJoe@aol.com
> *Sent:* Saturday, 24 May 2008 1:43 AM
> *To:* Multiple recipients of list OB-GYN-L
> *Subject:* Re: vbac on demand
>
> In a message dated 5/23/08 9:54:06 AM, ajfields@pine-net.com writes:
>
> Would that be that the physician's right to do whatever he wants trumps
> the patient's right to informed consent? Or that the physician's legal
> and financial risk are more important than the patient's physical risk?
> Because I really can't see how the relative risks aren't important to
> this woman's decision about her body.
>
> There are two "rights" here (if you ignore the baby's right):
>
> 1) The woman's right to take whatever risks with her body (after being
> informed what the risks are).
>
> 2) The physician's right to practice what he feels is good medicine (i.e.
> not be forced against his better judgment into a course of action that he
> feels is unacceptable, given the standards, the circumstances, etc.).
>
> How you balance those two "rights" is the question.
>
> We all talk of #1 a lot, as we should. But #1 does NOT automatically
> overrule #2, by any means.
>
> And sometimes, although I may be getting ahead of the argument here, there
> is no easy solution to the problem and it ends up being decided on policy
> grounds (e.g. you can't have patients willy-nilly showing up at hospitals
> and demanding unacceptable procedures or treatments when the doctors don't
> think they're warranted -- it would make the "system" unworkable).
>
> Joe P.
>
2)
>
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--
R. Daniel Braun, MD FACOG(L) ABMP CMTh
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
--
R. Daniel Braun
"Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
