Bioethics Discussion Blog: Power of a Fetus vs the Autonomy of the Mother and the Carder Court Reversal Decision

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Monday, August 13, 2007

Power of a Fetus vs the Autonomy of the Mother and the Carder Court Reversal Decision

You are a woman and you are pregnant. You are at term, in labor, and you have been fully informed by your doctor who insists that you deliver by C-section otherwise the baby might not survive. You have previously told your doctor that you never want a C-section operation and you are sure that you can deliver vaginally as you did with your other child. Your doctor is upset with your refusal for surgery.. the doctor is angry that you will not listen to medical advice. Guess what? The doctor and the hospital are contacting the court for an emergency order by a judge to perform a C-section against your wishes. The fetus is, at this moment, more important than your autonomous decision.

You are a pregnant woman with cancer and needs chemotherapy. Your fetus is viable but the doctors don't want to treat you for your cancer until they protect the fetus by removing it from the womb otherwise the chemotherapy will poison it. You are fully informed about the benefits of chemotherapy and the potential risks to the fetus and yourself. They get a court order to perform a C-section against your decision to treat your cancer now and not be concerned at present with the fetus.


You are a pregnant woman and have been voluntarily snorting cocaine. You have heard that there is some controversy that cocaine may be harmful for the fetus but, nevertheless, you consciously decided that you wanted to continue the drug. You are arrested, convicted of harming your fetus by the cocaine and you are now in prison.

If you think these stories are all made up, you are wrong. This is what has been happening in the United States. It appears that legislatures and the federal government put more power in the unborn denying the born pregnant woman the autonomy regarding the control of her body, such autonomy being granted to every adult woman or man. The unborn, through court order, can lead to personally unwanted and perhaps unneeded operations or other procedures carried out on the woman's body. Even a born infant or other born child of the mother would not be granted such power. So why the unborn fetus?

Read the Angela Carder story of a young lady whose drive for her own survival from cancer caused her and her fetus to become the fatal victims of a court decision. Read about the entire subject of "The Rights of Unborn Children and the Value of Pregnant Women" in the Hastings Center Report. And finally, read the advice of the American College of Obstetrics and Gynecology regarding autonomy of pregnant women in view of the D.C. Court of Appeals reversal of the initial court decision regarding Carder but after both the mother and fetus had died.

Although the word has not fully gotten around to all the doctors, lawyers and legislatures and federal government, the courts are not the ones to be ordering surgery and other procedures on women who are pregnant against the woman's autonomous decision in order to attempt to preserve the life of a fetus. In fact, no one, even doctors may do so either. ..Maurice.

4 Comments:

At Monday, August 13, 2007 5:42:00 PM, Blogger MY OWN WOMAN said...

I'm so stunned I don't even know what to say. I thought I had control over my own body and it appears that I don't. Scarey stuff.

 
At Monday, August 13, 2007 7:21:00 PM, Blogger Maurice Bernstein, M.D. said...

My own woman, ..and I can tell you a common basis for this violation of a woman's body and will--fear of a malpractice suit. As you may know, the risks of suit and a loss for the obstetrician is very high and is reflected by the high cost for the OB to buy malpractice insurance. So when a pregnant woman presents with a possible difficult delivery, the OB is also thinking about the end results in terms of malpractice when he or she gives advice regarding further management. This advice may be in reality "over the top" in terms of what clinically is necessary and if rejected by the patient, under some circumstances the physician may panic and look to ethics committees and the courts to solve the dilemma. What the physicians forget is that the fully informed patient has every right to reject the physician's advice and if the communication between the two was well documented the responsibility for the subsequent complications by not following advice would be directed to the patient. To "force" the patient into a treatment (like strapping the patient down--noted in one of my resource links or something less than that)is unethical and unprofessional and easily could represent legal battery.

This problem in the patient-doctor relationship could be eased by keeping the courts out of medical decision making and by eliminating the host of unnecessary,unwarrented and perhaps simply frivolous malpractice law suits presented to obstetricians. ..Maurice.

 
At Tuesday, August 14, 2007 6:11:00 PM, Blogger MY OWN WOMAN said...

I've often wondered how many medical law suits or even other law suits would be filed if the "loser" be it the plantiff or the defendent had to pay the monies being sued for.

I might even chuckle if a patient sued the doctor for not clipping his toenails and when the toenails were produced in court by the doctor, the patient had to pay the doctor the $1K that he originally sued the doctor for. I wonder if the law suits would dwindle.

I don't think that time is coming soon, but it is fun to dream.

 
At Tuesday, August 14, 2007 7:03:00 PM, Blogger Maurice Bernstein, M.D. said...

My own woman, doctors have sued the original plaintiff for frivolous suits and a few have won. But to automatically cause the malpractice suit loser to pay the winner..that would be great. It would certainly cause some caution in starting any suit.

The other approach would be following the expression of consern about the Los Angees Watts Riots in 1991, Rodney King asked in a news conference "Why can't we all get along?" Maybe, in terms of the approach to the doctor-patient medical care relationship, answering that question and using the facts for constructive mitigation would do a lot more good than filing malpractice suits and making doctors worried and practice inappropriate and expensive defensive medicine. At the same time, researching this question and acting on it might make patients feel happier and more confident in their doctor and their treatments and and reduce the need to express the words "I hate Doctors" ..Maurice.

 

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