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Re: A caseFrom: Robert J. Woolley (wooll005@gold.tc.umn.edu)Mon Dec 2 22:12:17 1996
In message <961202191748_1422381543@emout12.mail.aol.com> writes: > > In a message dated 12/2/96 4:14:39 PM, you wrote: > > <<I would not fault anybody for inducing this patient, so don't get > distracted from my main point by that issue. But I have to disagree with > the way you frame this. The default condition in obstetrics (in all of > medicine, actually) should always be to do nothing, unless there is good > reason to believe that intervention will benefit the patient. IMHO, > having to "give one good reason" for not intervening is a manifestation > of a backwards way of clinical reasoning; it tacitly assumes that > invervention is correct unless proven otherwise.>> > > I have to disagree. In OBSTETRICS (OFTEN unlike the rest of medicine), a ripe > cervix at term leads to the "bird in the hand" simile. With severe > oligohydramnios, deccelerations, etc, this lady CRIES OUT TO BE INDUCED. > > Joe P. Then you're not disagreeing. You are making the determination that there is sufficient benefit to be gained to justify leaving the default condition (non-intervention) and go for the intervention. That is appropriate. I'm criticizing the thought process by which the decision is arrived at. Starting with the assumption that one should always intervene unless given a good reason not to is bass-ackwards.
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