Re: episiotomy and shoulder dystocia wasits effects on perineal body/

From: Timothy C. A. Brown, M.D. (tcab1@idt.net)
Mon Apr 28 11:50:49 1997


At Sun, 27 Apr 1997, Garry E. Siegel, M.D. wrote: >
>At Sat, 26 Apr 97, Robert J. Woolley wrote:

>>So you cause injury, pain, and risk--with zero benefit--to your patient for a
>>hypothetical benefit to yourself. The very definition of "unethical" in my book.
>>
>Dear Bob:
>

>I may be old fashioned, traditional, unwise, uneducated, and many other
>things, but I don't think unethical is one of them.

Let's talk definitions. ethical, adj. 1. pertaining to dealing with morals or the principles of morality; pertaining to rignt and wrong in conduct. 2. in accordance with the rules or standards for right conduct or practice, esp. the standaards of a profession.

Bob is using definition 1, i.e. immoral, while Garry is using definition 2. Since routine episiotomies are not outside the standard of care, doing one cannot be unethical in the sense of definition 2 regardless of the motivation. Another more in your face example of this is that abortions may be immoral but are not unethical. On the other hand if we agree that it is not right to do an episiotomy purely for legal considerations then it would be unethical in the sense of definition 1 to do one.

Garry and Bob are both right, but I would suggest that in this forum we stick to definition 2 and use "immoral" or better yet "not right" or "wrong" instead of definition 1. Everyone is entitled to their opinion but it would be nice to see a little more courtesy.

My $0.04 worth.

--
Tim Brown
Private Practice
Long Island, New York

"Life is not breath, but action . . ." Jean Jacques Rousseau





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