Sunday, December 19, 2010
Courageous Or Foolish?
Every once I a while, a story catches my eye as I scan the news websites. There was one this morning on CNN with this catchy title, "Mom Defies Doctor, Has Baby Her Way." The article describes a story where mom was going to have her fourth baby. Her previous three were born via C-section. Mom did not want another C-section done, and "defied" her doctor's order for the procedure. "You're being irresponsible," the patient was told.
The middle of the article talks about the current thinking and statement of the American College of Obstetrics and Gynecology saying that "it's reasonable to consider allowing women who've had two C-sections to try to have a vaginal delivery." Of course, there's risks with proceeding with a vaginal delivery and risks of another C-section.
What's always interesting to me are the comments following the article. I applaud the physicians in there who are fighting back the anti-physician sentiment and those who are pushing (no pun intended) the only home birth agenda.
In this article, this person is being held up as a hero - as someone who defied the paternalistic medical establishment and did it her way. Good for her, or is it? What if that 0.4-0.9 percent possibility of severe complication occurred and there was a problem with mom and/or the baby? What would happen then?
According to the court of public opinion, there would be always someone to blame for the bad outcome, and I'm not thinking that people would be pointing fingers at mom. They would of course, people would be blaming the doctor and the entire medical establishment for not fully explaining the risks of a choice like this. And, of course, there would be the usual lawsuits when a bad outcome happens.
My point is this. I'm all for patient empowerment, and I have written about the rise of the e-patient (empowered patient), in the past. But, in the US healthcare system, there is still not enough patient responsibility that has occurred among all patients. Good outcomes are usually attributed to patient's taking initiative and bad outcomes are usually attributed to bad doctors. This frustrates me. Isn't there somewhere in the middle that both those perceptions can meet?
at 1:39 PM