On one of my lists, a discussion about how a mom or dad would refuse a procedure in Canada included the information that there doesn't seem to be any such thing as a refusal form there. How can that be?
I know care providers who work so hard to deny a "patient's" rights to consent - oh, it's the law... you have to do
(I can hear the argument already, actually. Because we are the ones who will have to treat your sick baby because you didn't give them
However, if a woman knows why she doesn't want a certain procedure, is it really right to strong-arm her into your type of compliance? Why not document the patient's choice and move on with it.
Perhaps there are a few folks that hear in class they might re-consider a Vitamin K shot or administering Erythromycin eye ointment, but don't really know why they might not want them. Someone might want to explain - offering some informed consent - and let them decide. Instead, what I've seen myself and heard from others includes the worst case scenarios of death and destruction. For goodness' sake, these are parents with pediatricians and access to medical care if anything untoward seems to be happening!
I think the worst right now is the GBS issue. God forbid a woman refuse antibiotic treatment in labor. Never mind that Europe doesn't treat GBS in the same hysterical manner as the CDC and OBs seem to; killing off every normal flora in two bodies is superior to treating a baby with GBS once it is out.
Yes, I have seen babies with GBS. Yes, I know of two that have died (they were not my clients' babies). I also know the babies that died did so because the parents didn't understand the symptoms clearly enough and didn't seek help soon enough. I know GBS can hit hard and fast, but in the major metropolitan are I live and work in, speed isn't the issue it would be if I lived in the mountains of Idaho or plains of Montana.
In Europe, parents are taught what to look for in newborns (remembering that GBS doesn't just affect the newly newborn, but can also cause illness in older newborns) and taught to bring the baby in if there are any questions - or the local midwife makes a visit to assess and refer.
I understand that here in the States treatment on L&D wards tends towards a give-and-get-anything-possible-in-case-we-never-see-them-again mentality, but when someone has researched, has information on risks and benefits, has a back-up plan of what to do if, and still wants to refuse a procedure or treatment, then why can't they be left alone?
Why do doctors and nurses seem to take it so, so personally if a parent exerts their personal desires? Is it that hard to step outside the dance of labor and delivery for half a second to curtsy to the individual who has a brain and a separate need than the herds of sheeple they typically see? Does seeing the patient as an individual - a person - carve into their thick dividing line between clinical care and heart-touching compassion?
Ah, but I think that is a separate issue best discussed in another post.
When I have clients who ask me, "Do I have to do a GTT/AFP/sono/PKU/Vit K/ E-mycin/GBS test/antibiotics/rupture of membranes/vaginal exam/STI testing/etc."
My answer is:
My job is to offer the smorgasbord of options - each dish having the ingredients listed in front of it. I will tell you what the standard of care is in the medical world and the midwifery world, then set you free to research on the Internet. You tell me what you want and I honor it.
That prospect is so foreign to too many women. The possibility of being believed, trusted, honored in their wishes is shocking to so many.
It shouldn't be that way.