An article came across my email today - When Doctors, Patients Clash: a solution - subtitled: More than ever, hospital ethics committees, patient advocates are being asked to settle disputes.
The paragraph that intrigued me most was this one:
C-sections are a common source of ethical disputes and have resulted in high-profile lawsuits nationally after women felt they were coerced into surgical deliveries. The rate of C-sections has increased from 21 percent of all U.S. deliveries in 1996 to 29 percent in 2004. The increase is partly the result of patient demand for the very scheduled and predictable method of delivery, but it is also due to doctors practicing "defensive medicine" and discouraging vaginal deliveries if there is even a slight chance of complications.
This is the very first time I have EVER seen anything in mainstream writing about women feeling coerced into surgical deliveries. I want to know what high-profile lawsuits they are talking about. Anyone know of even one such lawsuit? Are women really beginning to sue for wrongful cesareans?
Another question. Can a patient advocate employed by the hospital be fair in his/her dealings regarding the hospital and doctor's advice? Is there such a thing as an on-call outside mediator? Is there a need for such people? How can someone be fair if they don't understand natural birth and all it entails spiritually and emotionally?
In most hospitals, patients have two options beyond their immediate caregivers. They can seek a patient advocate — a social worker or nurse designated to argue on behalf of patients. They can also request a formal ethics consultation — a roundtable of ethics and medical experts who supply an objective viewpoint to a medical dilemma.
Unlike an X-ray or ultrasound, an ethics consultation doesn't have to be ordered by a physician. Anyone can make the call. Nurses disagree with doctors. Doctors believe relatives are demanding excessive care for loved ones. Patients refuse doctors' recommendations.
Did anyone know there was this option in birth? Is this something all hospitals have? I knew about Patient Advocates, but never thought to call one in for a birth going like shit because of a power-hungry physician. I can think of at least 5 births where a patient advocate would have bought more time before a cesarean happened - getting the negotiator, expository time, negotiation time - all for the babies' (and mothers') advantage.
Are we who work in birth as doulas and midwives going to tell our clients about Patient Advocates now? How will we find which hospitals have them and are willing to negotiate in the middle of labor? Can we do in-services for these advocates?
Ethically, is there a conflict of interest that can be negotiated (maneuvered around)? What is the doula/midwife's role in middle-of-labor misunderstandings and conflicts? Who speaks on the mother's behalf when she is in the throes of labor, in excruciating pain, or uncontrollably angry and filled with fear? Is this her partner's role?
I want to hear how others will use this information for their clients' benefits. I, for one, will be doing some delving and exploring.