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RESPONDING PROFESSIONALLY TO REQUESTS FOR CESAREAN DELIVERY.

F Chervenak1, L McCullough1

  • 1Weill Medical College of Cornell University, Department of Obstetrics and Gynecology, New York, USA.

Georgian Medical News
|August 19, 2017
PubMed
Summary

Obstetricians should recommend against non-indicated cesarean deliveries, prioritizing vaginal birth. A preventive ethics approach using informed consent is key to managing patient requests and upholding professional responsibility.

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Area of Science:

  • Obstetrics and Gynecology
  • Medical Ethics
  • Preventive Medicine

Background:

  • Patient requests for non-indicated cesarean delivery present ethical challenges for obstetricians.
  • Physicians are ethically bound to practice evidence-based medicine, avoiding interventions without clear clinical indications.

Purpose of the Study:

  • To explore a nuanced ethical and clinical approach to managing patient requests for non-indicated cesarean delivery.
  • To advocate for a preventive ethics model utilizing informed consent to mitigate ethical conflicts.

Main Methods:

  • Application of the professional responsibility model of obstetric ethics.
  • Utilizing the informed consent process to focus on recommending against cesarean delivery.
  • Reviewing evidence regarding the clinical benefits of non-indicated cesarean delivery.

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Main Results:

  • There is no demonstrable net clinical benefit for pregnant individuals, fetuses, or neonates from non-indicated cesarean delivery.
  • A simple "No" may not be the most effective or ethically sound response.

Conclusions:

  • Obstetricians should recommend against non-indicated cesarean delivery.
  • Promoting vaginal delivery and educating patients on the evidence base are crucial.
  • A preventive ethics approach enhances professional responsibility in obstetric practice.