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Entries in Informed Consent (2)


Sacred Trust

Science & Sensibility’s post today, Sacred Trust of 24/7, speaks, almost gingerly, of the Sacred Trust between a physician and a patient. Dr. Michael Lu says:

“I know I could talk my patient into anything, and most OBs know that.  But that’s a misuse of that trust.  Yet there is that sacred trust.  I don’t know how to change that culture.  Maybe the trust is misplaced.  And this is what I haven’t figured out, if we replace the OB with a team, can you have trust in a team the same way you have a trust in your OB?”

But, it isn’t just with OBs that this trust occurs… and is exploited, but also with midwives. One needn’t look far to see this in motion every single moment of the day.

-         No, you don’t need IV antibiotics; Hibiclens does the same thing.

-         No, you don’t need Vitamin K; it causes leukemia anyway.

-         No, you won’t need Pitocin; we have herbs for hemorrhage instead.

-         No, you don’t need to go to the hospital; you’re just taking longer than normal, but it’s okay.

-         No, you aren’t taking longer than normal; it’s just a variation of the norm.

-         No, you don’t need antibiotics; just take cranberry capsules and drink lots of water.

-         No, you don’t need to be induced; some pregnancies just go over 42 (43, 44) weeks.

-         No, you don’t need to take the GTT; Gestational Diabetes doesn’t really exist.

I could go on and on, but you get the gist.

We in the Natural Birth World are even taught to distrust everything an OB says, but who teaches how to decipher who is telling the truth or not? Why are the very few of us who suggest there be some discretion with what midwives say vilified? I don’t understand how a woman can put her all her trust in one set of letters after a name and not any in another set of letters (or lack of letters!).

Perhaps the UCers are nodding and saying, “See! This is why we only trust ourselves!” But, even that isn’t true because they’ve been sold a bill of goods as well, that birth is always normal and good with a great attitude and no fear.

Who really speaks for the woman? Who are the providers (or doulas) who tell the truth? How can a woman find a Truth-Teller? I don’t know if there is any specific way for a woman to know if her provider is completely on her side except through referrals and her own examined experience.

I really, really love the idea of a group discussion, not just a second opinion, but a nurse, doctor, midwife and maybe another doctor, who decide if a woman gets cut or not. My own preference, of course, would be an experienced doula in the mix, but that would be a fantasy stretch for providers to consider. And I know in the case of emergency, there’s no time to create a quorum, but the great majority of cesareans are not that type of emergency.

Do others have ideas on how to know if a provider really is giving complete Informed Consent or just offering what s/he is capable of doing? This is a really important question and one I hope will be asked amongst the different factions of the Natural Birth Community.


Open Season: you have been warned

The Internet has no walls. 

It pays to remember that. While I am meticulously careful to not talk about clients on-line or in articles/posts without their permission, there is a whole different set of rules when reading through the Internet’s public domain. 

Therefore, I am serving notice: If you write something publicly, whether in a blog, in a comment in a blog, in a comment to a newspaper or magazine article, in a comment to someone’s post… my spring boarding off of it is fair game. IF YOU DO NOT WANT ME OR ANYONE ELSE TO WRITE SOMETHING ABOUT YOUR WORDS, MAKE YOUR BLOG PRIVATE OR DON'T WRITE IT IN THE FIRST PLACE

If you are in Facebook with me, I might just use the context of what you are saying, without using your name, when I write something to be seen publicly. I will not quote or reveal discussions in private chats, Skype sessions (without okay) or in private emails. If you have friends that comment to something said in Facebook, their context is also fair game. IF YOU DO NOT AGREE TO THIS, UNFRIEND ME NOW

Note to public figures (and you know who you are): You and your words, wherever they are, are fair game. I grudgingly agreed to ignore one very important comment made in Facebook a couple of weeks ago. I WILL NOT DO SO AGAIN. If your words come over my Newsfeed, you and your words may very well be written about. If I find them randomly over the Internet, they are also fair game. 

Netiquette continues evolving and I do try to keep up on the legalities and ethics of writing on the Internet. There seems to be confusion lately about a writer’s boundaries, some thinking it should be here and others agreeing it can be way over there. I am laying out my boundaries so there is no longer any confusion when it comes to my writing. 

Remember, the Internet has no walls.