Probably should send this one to Pesce if you already have not. Judy
--- Denise Hynd <[EMAIL PROTECTED]> wrote: > > Subject: RE: [MCMgtCte] FW: Article re. caesars.... > > > See: http://www.forensic-psych.com/articles/artMedMal.html > > > > A Plaintiff's Verdict: Meador v. Stahler and Gheridian - > The $1.5 million award to a Massachusetts woman and her family > in Meador v. Stahler and Gheridian3 made news as a rare > instance of a malpractice judgment based on an allegedly > unwanted and unnecessary cesarean section rather than a > failure to perform such an operation. The plaintiff, Mary > Meador, did not claim that the procedure was negligently > performed or that the rare and disabling physical > complications that resulted from it (which left her largely > bedridden and unable to work or meet her family > responsibilities for several years) were foreseeable. Instead, > she claimed that the defendant obstetricians had > misrepresented the risks of the alternative procedure (vaginal > birth after prior cesarean) and ignored her persistent pleas > for this alternative. Moreover, she alleged, they compelled > her passive assent to the surgery in an emotionally coercive > manner while she was progressing normally in labor, despite > their having previously agreed to such a trial of labor. - > Because the consequences of the cesarean were unforeseeable, > and because Meador had signed a consent form for the surgery > (to be used in case of emergency), this case did not meet the > technical requirements specified under Massachusetts law4 for > an action based on informed consent. Instead, the case was > brought on the theory that the physicians' failure to obtain > the patient's informed consent constituted substandard, > negligent medical care. The forensic psychiatrist's expert > testimony emphasized that the pro forma signing of a consent > form did not constitute true informed consent, especially in > light of the physicians' alleged disregard of the patient's > expressed wishes and their inaccurate representation of the > risks and benefits of the approach she preferred. > - The psychiatrist also explained to the jury how Meador's > life history left her vulnerable to experiencing the denial of > informed consent as a highly traumatic event. Having coped > since childhood with serious illnesses in her family, Meador > had viewed doctors and nurses as nurturing figures who helped > her gain control of potentially tragic situations. She had > learned that choice was still possible even amidst illness and > death. She had even been inspired to become a nurse herself > and to teach this discipline to others. Thus, when she > experienced a sudden loss of choice and control during > childbirth, she reacted with intense fear and horror and felt > she had been betrayed by health professionals, whom she now > feared and mistrusted. In this way she lost her accustomed > strategy for coping with life. Moreover, having helped hold > her original family together in the face of tragic illness, > Meador saw the family she had created torn apart by her sudden > and devastating loss of control in a medical situation. The > jury's recognition of the importance of the emotional facts of > the case was highlighted by its awarding almost one-third of > the total damages for loss of consortium. - > Thus, it was not simply the physically disabling consequences > of the surgery, but the loss of personal decision-making power > concerning her body, her health, and the birth of her child, > that caused Meador to suffer from Post-Traumatic Stress > Disorder. Similarly, her husband's experience of loss of > consortium was exacerbated by the physicians' failure to > consult him to interpret his wife's wishes during labor. > Instead of having participated in a true informed-consent > process, he was left to feel powerless and helpless. In this > way, forensic psychiatric testimony established a persuasive > causal link between the lack of informed consent and the > physical and emotional damages suffered by the patient and her > family. > > > > Cheers, > > > > C > > > -------------------------------------------------------------------------------- > > Subject: [MCMgtCte] FW: Article re. caesars.... > > > > The Midwife Strikes Back.... This is timely with NCAD next > weekend but I > must say Andrew P has his facts wrong. A woman sued an OB for > an unnecessary > cs in the US and this year won! > > Cheers, > > Subject: Article re. caesars.... > > http://www.news.com.au/story/0,10117,16490659-421,00.html > > One third of Australian births to be caesars > > By Adam Cresswell > 05-09-2005 > From: The Australian > > THE number of women giving birth by caesarean section is > rising fast, and > could soon hit a record of 32 per cent of deliveries - far > higher than in > countries such as Britain and New Zealand. > > There are more than 250,000 births a year nationwide, and > emerging hospital > data indicates the increase in caesarean rates since the > mid-1990s may be > accelerating. > Sally Tracy, associate professor of midwifery practice > development at the > University of Technology Sydney, told The Australian yesterday > the > calculations were based on trends in hospitals and the > experiences of > midwives in practice. > > "Judging from the trends in tertiary hospitals, the caesarean > rates are just > soaring," she said. > > "Midwives are saying things to me like, 'I can't keep working > - every single > woman on my shift has had a caesarean section'. They feel > totally powerless > to do anything about it." Not only are caesarean rates much > higher than in > many other countries, they are also rising far more quickly. > > Professor Tracy presented the figures at a conference in the > coastal NSW > city of Newcastle on Friday. > > The last official national statistics on caesareans date from > 2002, when 27 > per cent of the 255,092 babies born that year were delivered > by the surgical > procedure, which involves cutting through the wall of the > uterus and > delivering the baby through the opening. > > In Britain last year, the caesarean rate was 23 per cent, and > Professor > Tracy said the New Zealand rate was similar. > > The reasons for the sharp increase in Australia were difficult > to establish > conclusively, Professor Tracy said, but more than 80 per cent > of women who > had a caesarean for their first child went on to have > caesareans for their > subsequent children. "They are coming back and not necessarily > being > encouraged to have a vaginal birth," she said. > > "It's the whole madness of technology - the biggest risk > factor for any of > these things is to have private obstetric care." > > A study published in the US journal Obstetrics and Gynecology > this year > found women given epidural pain relief were more than five > times more likely > to have a fetus in the posterior position - a difficult > position for vaginal > birth, making caesarean delivery much more likely. > > Professor Tracy said midwife care was known to be associated > with fewer > epidurals and interventions, and an expansion of midwife care > could be check > the rising caesarean rate. A study published in the British > Journal of > Obstetrics and Gynaecology in 2001 found 1089 women randomly > assigned to > community midwife care or standard hospital care were 40 per > cent less > likely to have a caesarean if they were treated by midwives, > she said. > > "If you look at countries like Canada, the UK and New Zealand, > they do not > have a very big presence of private health insurance, and they > don't seem to > have the same high rate of caesarean sections." > > Andrew Pesce, consultant obstetrician at Westmead Hospital in > Sydney, told > the conference litigation was a factor in the caesarean rates. > > No obstetrician had ever been sued for doing a caesarean, > while some of the > largest medical negligence payouts - including the $11 million > Calandre > Simpson case in 2001 - followed claims the doctor should have > performed a > caesarean section earlier, Dr Pesce said. > > > > > > > > > > -------------------------------------------------------------------------------- > Yahoo! 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