Informed Consent...Angela Carder Case

[doulajamie]

I brought this up under another thread and was asked to move it to its own. It's a very interesting case and I find it infuriating on many levels. It should make for a lively and interesting discussion. Here's the link to the information on the case (if anyone wants the detailed court notes, let me and I'll go to Lexus Nexus and retrieve it for you).
http://www.advocatesforpregnantwomen...les/angela.htm
Jamie

[DoulaCBE]

I read it in the other thread with much interest.

I had a passing thought of having it printed out in my doula bag if I were to ever face the threat of a court ordered cesarean with a client, but thankfully our birth environment is at that point, yet.

[DoulaCBE]

No one is going to nibble this one?

There's enough in that one article to keep us talking for weeks.

To start it's proof positive that it's a slippery slope when you put a fetal rights before that of the woman.

[doulajamie]

ACOG guidelines when the patient refuses treatment:

"The use of judicial authority should be avoided unless: 1) there is high probability of serious harm to the fetus in respecting the patient's decision; 2) there is a high probability that the recommended treatment will prevent or substantially reduce harm to the fetus; 3) there are no comparably effective, less intrusive options to prevent harm to the fetus; and 4) there is a high probability that the recommended treatment also benefits the pregnant woman or that the risks to the pregnant women are small."

Then let's look at the Federation Internationale de Gynecologie Obstetrique (FIGO) ethics:

"No woman should be forced to undergo any procedure in order to preserve the life or health of her fetus, as this would be a violation of her autonomy and fundamental human rights"

In this case, I don't see either code of ethics being followed. In fact, a doctor overestimated the baby's ability to survive, the cancer specialist was not called into court, and the mom's desire to live and beat cancer was overlooked in an effort to "save" a fetus that is thought to have already been brain dead. It's easy to talk about informed consent/informed refusal but does it really exist?

Here's a quote that just bites (it's from a doctor) but seems to the principle in play in this case: "The doctor should override the patient's irresponsible refusal". WTH???? who decides what is irresponsible? How would you feel if you or one your patient's refusal was overridden by the doctor?

Jamie
REFERENCE:

Van Bogaert, L. J. (2006). Rights and duties to non-consenting patients--Informed refusal in the developing world. Developing World Bioethics, 6(1), 13-22. [Electronic version].

[melba]

Man, I only have a minute but there is soooooo many things wrong with this case. The fact that the minimal chance the fetus would survive was placed higher than the HUGE chance of maternal death...unbelievable. This is the danger of fetal rights...the slippery slope...Be back later with more...

[earthgirl]

Quote:

Despite the court's order, the obstetricians refused to carry it out. The hospital was then in the ironic position of being in contempt of an order that the hospital itself had sought. Reluctantly, a staff obstetrician agreed to perform the surgery.

Interesting. I didn't know that about this case.

Quote:

she said repeatedly, "I don't want it done." However, this declaration did not sway the hospital to withdraw its petition or the court to amend its order

Quote:

Minutes later, having just been told that she probably would not survive the surgery, the woman who had courageously cheated death for fourteen years was rolled into the operating room. The fetus died within two hours. Two days later, Angela Carder died, never having received the cancer treatment she requested.

How unbelieveably sad.

Quote:

without complete or accurate medical information or time for legal research and arguments, the judge erroneously made an impermissable trade-off between Angela and her fetus.

For sure.

[helpinghands]

I have lots of thoughts on this issue but am unable to organize them right now with my 5 children running circles..BBL after I chew on this for a bit.