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Re: A case From: Robert J Woolley (wooll005@gold.tc.umn.edu) Tue Dec 3 08:40:56 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Re: Fundiscopic exams" Previous message: Jeffrey W. Clemens: "Personal Ancedote" In reply to: pauleun@MEM.po.com: "Re: A case" Next in thread: Jason Gardosi: "Re: A case" On Tue, 3 Dec 1996 pauleun@MEM.po.com wrote: > > > 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.... > > In an ideal world, above statement would make a good sense. However, if > one did not intervene in the case presented here and had a bad outcome > such as fetal demise, it would be VERY difficult to defend in this > country! In other words, risks of expectant management are greater > than the risks of induction of labor for this fetus. > I feel like Paul Riser, trying to explain AT&T's new rate plan: "Am I just being unclear?" Look, I stated explicitly that I do not disagree with the conclusion, only with the thought process. The thought process always ought to have non-intervention as the default condition, with the decision *to* intervene only made when there is good reason to think it will benefit the patient. In this case, I think there is. What was wrong was the clear implication of the thought process being: "Intervene unless there is good reason *not* to." It is that to which I object. And I reiterate, in re your last comment: deciding what to do based on fear of malpractice suits is a fundamentally wrong-headed way to practice, though all too common among physicians today, especially ob/gyn. Do what is best for the patient, not what you are motivated to do out of malpractice paranoia. Next message: Richard Chudacoff, MD: "Re: Fundiscopic exams" Previous message: Jeffrey W. Clemens: "Personal Ancedote" In reply to: pauleun@MEM.po.com: "Re: A case" Next in thread: Jason Gardosi: "Re: A case"

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