Physian refuses to save a woman's life...

[charbie]

It would be interesting to hear the other side of this story. If the doctor did simply refuse to try to save the life of this woman, then he certainly doesn't need to be working in the ER. I beg to differ with Circe that this does matter to some of us whether this was a medically necessary delivery of a pre-term baby or an abortion. I totally understand the need to deliver this baby early if it was the only option to save the mother's life and do not in any way consider it an abortion. Just because abortion is legal does not make it morally right, and truthfully, there are rare circumstances where it is medically necessary. Again, if this doctor was not doing all in his power to save the woman's life, including the emergency c-section of the baby, he was absolutely wrong. But I do absolutely respect the right of any physician to refuse to do a non-medically necessary abortion.

Argh. Diamondseeker, I have no interest in debating the "morality" of abortion: I'm pointing out that the care that she needed does not qualify as an abortion in the eyes of the law, the sane, or, for that matter, this thread. The fact that the doc in question apparently put his status as "never performing abortions" (by his own definition) ahead of the fact that her baby was already dead and she'd soon be following it without proper care is the part that's problematic, the part that makes him unprofessional, and the part that illustrates how wonky our health-care system is.

For starters, there's no way it could be considered "medically necessary delivery of a pre-term baby" - at 20 weeks, the baby would not have been viable, and as she observes in the article, given the degree of hemorrhaging "everyone [at the hospital] knew the pregnancy wasn't viable, that it couldn't be viable given the amount of blood I was losing."

You won't catch me arguing that a doctor has to provide elective surgery, of any sort, not abortion, not a face-lift, not the surgical implantation of a pair of horns. But for an ER doc to pick and choose his procedures? Not okay.

Pharmacists, for me, fall into a different category: if they don't want to prescribe legal drugs, they should find a different line of work. Street preaching might be up their alley.

Circe, I agree with you on the points you've made, especially where you said he has his own definition of abortion. That's was what I was trying to get at...there is a difference IMO between an abortion and his definition. If he does not want to perform emergency medicine on pregnant women, his hospital needs to either come up with a back up plan or not allow him to practice in this capacity.

As for pharmacists, my father actually was a pharmacist. In his area, they always had to have a someone reasonably available to dispense medications others pharmacists felt uncomfortable giving.

 

[Circe]

Circe, I think we technically agree that he had an obligation to treat this woman aggressively to save her life. But we've had doctors on here who said the proper procedure would have been to deliver the baby by c-section. I am agreeing with you that he was wrong in his refusal to treat her on grounds that he does not perform abortions. But the article doesn't completely make any sense because this wasn't really an abortion scenario. Pro-life doctors certainly are pro-life for the mother! (or normally are!)

I think the key to understanding the scenario is in, a) the point she was at in gestation (at 20 weeks, a c-section won't save the baby - 23 weeks, maaaaaaaaaaaaybe, and that's a stretch given where our science is), and, b) the severity of the bleeding and loss of amniotic fluid.

But it looks like she's been fielding a lot of like questions - she originally published that piece on her blog (Salon did a reprint), and she gos into the background/explanation in more details in the first post on her frontpage, here: http://mikkikendall.wordpress.com/.

Hope this will clarify! The funny thing is, when I was reading her blog, I kept feeling this niggling sense of familiarity - turns out, she's a blogger I've respected for a long time who's active in a lot of the same areas I am. Small, sad, world sometimes - while I'm proud to have some things in common with her, this is just a point of common sorrow.

 

[Circe]

Circe, I agree with you on the points you've made, especially where you said he has his own definition of abortion. That's was what I was trying to get at...there is a difference IMO between an abortion and his definition. If he does not want to perform emergency medicine on pregnant women, his hospital needs to either come up with a back up plan or not allow him to practice in this capacity.

As for pharmacists, my father actually was a pharmacist. In his area, they always had to have a someone reasonably available to dispense medications others pharmacists felt uncomfortable giving.

Thanks, Charbie - as far as I can tell, she did interact with the hospital board after her loss to improve their procedures. Good on her, I say.

 

[dragonfly411]

I call BS on this article. The article begins by complaining about a pro-life lawmaker and then descends into a pro-choice diatribe without any facts or names to backup the claims (i.e. what type of "procedure" she had). The treatment for severe placental abruption with hemorrhaging is NOT an abortion but immediate Caesarian delivery and then a hysterectomy.

Exactly this. It's not an abortion, the baby would be delivered and would not survive. The doctor was either a wackjob and completely incompetent or this is BS.

Rewording to say technically (Scientifically would probably be something long I can't pronounce) speaking, any pre-full term delivery is considered an abortion, whether the baby would survive, did survive, is alive or is not alive. We have to abort mares all the time when they have two dead twin fetuses.

I do think it is absolutely irresponsible and disgusting that no one did anything sooner for this woman. Any surgeon should be fully capable of performing any required procedure and they should have someone capable on staff/call at all times.

 

[jstarfireb]

Circe, thank you for the blog link. I found this part interesting:

As for the demands that I have a c-section just in case a micro-preemie could have survived? You should go look at the survival rates for 20 week preemies again. Death wasn’t going to be averted, it was just a question of whether we both died. There seems to be this assumption that major surgery was a better idea than a less invasive procedure. Umm..no. The first thing discussed when I got to the hospital was the lack of viability for a child born at that point, then there was the part where I was in active labor & had no amniotic fluid when they did the ultrasound.

So it sounds like we were wrong regarding which procedure she had. In that case, I stand by my original statement that the doctor on call shouldn't have done a procedure he wasn't trained to do in a woman bleeding nearly to death. (Whether all OB/Gyns should be trained to perform abortions is a separate issue.) This doesn't absolve the doctor or anyone else involved of any wrongdoing - far from it. Instead, they should have involved the other doctor much sooner, not to mention treating this woman's pain. The fact remains that she was treated with negligence because of politics, which is still despicable.

And just to be clear, when I mentioned c-section and hysterectomy, I wasn't referring to it as an attempt to save the baby - it was clear that the baby was lost regardless of what they attempted. She is absolutely right about the survival rates for 20-weekers. However, I didn't think the kind of bleeding caused by an abruption could be treated with a D&E - and for that I stand corrected.

 

[Black Jade]

I don't know if we so much need to debate whether doctors should perform abortions if necessary to save a woman's life, so much as look at the fact that currently in the U.S. only 3% of abortions are performed because of mother's health problems. Another 1% are performed because the pregnancy is the result of rape or incest, and a further 1% because there is some fetal abnormality. So these reasons account for 5% of the 1.2 million abortions performed per year. So--what's 95% of 1.2 million a year?

In the U.S. it is currently legal to perform an abortion at any stage of the pregnancy.

However, 88% of abortions are performed before the first twelve weeks. Only 1.4 percent are performed after 20 weeks. Here is the story of one of that 1.4 percent. I think it's interesting, and probably at least as representative as the dr. mentioned in the article which started this thread. Several posters have stated that his decision is far from the usual one in such cases. The young lady who speaks for herself in the article linked before is also unusual--but not unique. There are several other such survivors.

I was careful to pick an article about her without religious references in it. Notice that she isn't judging anyone--and neither am I. Actually I can't be judgmental about people who believe abortion is the best solution sometimes because I used to be one of them. I believed in it so much that I worked in a clinic for awhile, around the time when she was 'born'. I had been taught that a 'fetus' was not a baby but a collection of cells, and I truly believed that abortion was a important right.

http://www.telegraph.co.uk/news/uknews/1504652/Gianna-Jessen-was-aborted-at-7-months.-She-survived.-Astonishingly-she-has-forgiven-her-mother-for-trying-to-kill-her..html

 

[Circe]

I don't know if we so much need to debate whether doctors should perform abortions if necessary to save a woman's life, so much as look at the fact that currently in the U.S. only 3% of abortions are performed because of mother's health problems. Another 1% are performed because the pregnancy is the result of rape or incest, and a further 1% because there is some fetal abnormality. So these reasons account for 5% of the 1.2 million abortions performed per year. So--what's 95% of 1.2 million a year?

This strikes me as a deviation from the topic under discussion, because this is one of the 3% of cases* where surgery (which, btw, was not an abortion in this case by most normal definitions, as we discussed above - the fetus was dying and could not be saved) was necessary to save the life of the mother ... and because a fair number of doctors are using their feelings about the "other" 97% to deny them care. We can debate the morality of abortion elsewhere, but this particular seems like a pretty blatant violation of medical ethics.

*BTW, could you tell me where you got those statistics? Pure curiosity.

ETA: Got curious, because the article you linked to just seemed hugely implausible, and came across a fair number of pages suggesting Ms. Dessen was parlaying a not uncommon premature birth into a piece of anti-choice propaganda. Hm.

 

[Arkteia]

Imagine this woman needing not an OBGYN procedure terminating the pregnancy, but an emergency cardiac procedure. What would have happened? A helicopter would have been called, a call to a larger hospital with cardiac team would have been placed... I simply can not imagine "a miscommunication" in this situation! Yet in this woman case, basically, a severe, uncontrollable bleeding, an emergency, there was a mysterious "miscommunication". A miscommunication when someone is bleeding to death??? All that this doctor needed to do was personally call a surgeon, or an OBGYN and say, "look, we have a bleeding OB case. I do not handle them. It is an emergency". I can imagine real situation. Boy, we would be calling five, ten times! A doctor, a hospital, a helicopter. "Where are you, guys? A woman may die!"

As long as procedures involving termination of pregnancy are legal here, OBGYNs and surgeons should be trained to perform emergency procedures. Or choose another profession if they do not want to. If it were a small hospital and the doctor on call was a physician not trained to perform it, he should have immediately gotten in touch with a larger nearby hospital and delegated matter to them.

I am trying to avoid voicing my own opinion or hurting someone's feelings. But I think my father expressed it in a very good way. He said, "ultimately, it is the woman who bears, cares for and raises the child. Her road is hard. Let her decide."

 

[Black Jade]

I don't know if we so much need to debate whether doctors should perform abortions if necessary to save a woman's life, so much as look at the fact that currently in the U.S. only 3% of abortions are performed because of mother's health problems. Another 1% are performed because the pregnancy is the result of rape or incest, and a further 1% because there is some fetal abnormality. So these reasons account for 5% of the 1.2 million abortions performed per year. So--what's 95% of 1.2 million a year?

This strikes me as a deviation from the topic under discussion, because this is one of the 3% of cases* where surgery (which, btw, was not an abortion in this case by most normal definitions, as we discussed above - the fetus was dying and could not be saved) was necessary to save the life of the mother ... and because a fair number of doctors are using their feelings about the "other" 97% to deny them care. We can debate the morality of abortion elsewhere, but this particular seems like a pretty blatant violation of medical ethics.

*BTW, could you tell me where you got those statistics? Pure curiosity.

ETA: Got curious, because the article you linked to just seemed hugely implausible, and came across a fair number of pages suggesting Ms. Dessen was parlaying a not uncommon premature birth into a piece of anti-choice propaganda. Hm.

The article I linked you to was from the Times, U.K. This newspaper is not either a pro or anti abortion source. I don't know what pages you are referring to that suggest Ms. Jessen is 'parlaying' anything into anything else. Anyone who is curious can do a search of news articles on her and find plenty of articles that state the facts as to how she was born--to call this a premature birth is interesting phraseology, don't you think?, don't you think? If it becomes a 'premature birth' instead of an abortion when the child survives, what is it that you (or rather, the 'pages' that you quote) are saying, really?

Where do you find the statistics that a 'fair number' of doctors are denying women care when it is obvious that the child inside is already dead and that the mother will die without the necessary medical procedure? I thought that the article quoted was newsworthy because what this doctor did is so uncommon. The agreement in this thread is that the dr. was wrong in this (dare I say uncommon?) behavior. The most pro-life people I know are in agreement that this is unethical. One of my very dear friends, in fact, is alive today because when she was in a similar situation and the doctor explained that the baby was already dead, she agreed to have it done--which she would never have done if there was a chance that the baby would have survived.

There are a fair number of doctors who would and do refuse to perform actual abortions (which this was not). People who go into the medical profession because they are idealistic and would like to save lives and have studied fetal development in their scientific classes quite often would prefer not to be involved in this, especially in the 97% of cases that you refer to above. I assume that you are not suggesting that they should be forced to do so.

 

[Circe]

The article I linked you to was from the Times, U.K. This newspaper is not either a pro or anti abortion source. I don't know what pages you are referring to that suggest Ms. Jessen is 'parlaying' anything into anything else. Anyone who is curious can do a search of news articles on her and find plenty of articles that state the facts as to how she was born--to call this a premature birth is interesting phraseology, don't you think?, don't you think? If it becomes a 'premature birth' instead of an abortion when the child survives, what is it that you (or rather, the 'pages' that you quote) are saying, really?

Where do you find the statistics that a 'fair number' of doctors are denying women care when it is obvious that the child inside is already dead and that the mother will die without the necessary medical procedure? I thought that the article quoted was newsworthy because what this doctor did is so uncommon. The agreement in this thread is that the dr. was wrong in this (dare I say uncommon?) behavior. The most pro-life people I know are in agreement that this is unethical. One of my very dear friends, in fact, is alive today because when she was in a similar situation and the doctor explained that the baby was already dead, she agreed to have it done--which she would never have done if there was a chance that the baby would have survived.

There are a fair number of doctors who would and do refuse to perform actual abortions (which this was not). People who go into the medical profession because they are idealistic and would like to save lives and have studied fetal development in their scientific classes quite often would prefer not to be involved in this, especially in the 97% of cases that you refer to above. I assume that you are not suggesting that they should be forced to do so.

Dude, she's lying.

1) Abortion in the third trimester was illegal in California in 1977, barring severe and life-threatening medical complications on the part of the mother. So the idea of there being not just this woman's mother, but a room full of similar cases stretches the bounds of credulity: either it was a back-alley abortion, in which case, hey, yet more evidence for the strong need for legalization, or the woman is lying.

2) She says she isn't in contact with the birth mother, yet she has a surprising number of details about what happened: not a single story about her I've been able to dig up lists a single verifiable fact - medical institution, doctors name, anything.

3) She's a l'il confused about how a saline abortion works: you don't inject a caustic chemical into a woman's uterus, you inject it into the fetus - no burning sensation, no blisters (and generally used considerably earlier).

4) Acquaintances of the family describe them as being fanatically religious, and Gianna as joining the lecture circuit at a very young age.

So, yeah, my conclusion is that either the woman has been deluded by her adoptive family into believing that she was saved from horrific circumstances for a special purpose, or she's an out-and-out liar who's capitalizing off of the tragedy of a premature birth which caused cerebral palsy (but which she "miraculously" recovered from in the span of 5 months in time to run a marathon, with "proper" training - oy!). Either way, not what I'd call a relevant example, because I don't think she's an "abortion survivor."

As for the numerous cases of pharmacists and doctors denying women treatment using "morals clauses?" BJ, I think questioning the occurrence is sort of like questioning climate change - there's no point debating that it's happening, what's interesting is figuring out why, and what solutions we can provide. But there are two types of docs who opt-out - the kinds who opt not to specialize in women's health (including abortion), and the kind who opt not to provide basic triage because of their "morals." In the case of the former, though, we can start with George Tiller, though - a man who was murdered by an anti-choice "activist" for the crime of believing that women had the right to make decisions about their own bodies, and for providing them with the services that might help them in that aim, when their pregnancies threatened their lives, or when their children would be born with horrifying birth defects and suffer tremendously. I'd say cases like his are good explanation for why many doctors choose not to perform abortions as a matter of course - because lunatics and fanatics have managed to communicate the message that it's as much as their lives are worth. Big difference between "fear of domestic terrorism" and "morality." (Man, I wish I could scare-quote within the quotes proper, as I don't think there's anything "moral" about what the anti-choicers are doing.)

Again, none of this is relevant the article under discussion in THIS THREAD, which was not considered "news-worthy," as such: it's an op-ed reprint of a woman's blog, detailing a frighteningly common occurrence. That's the topic under discussion, and what I'd consider a glaring problem with our medical system. Can we stay on topic, please?

 

[Arkteia]

I see a certain double standard in all cases involving termination of pregnancy. Imagine a different situation.

Supposedly, a patient with internal bleeding (not pregnant at all) refuses a life-saving blood transfusion citing some religious beliefs. She is within her rights, it is her choice.

Now imagine a doctor watching a woman dying from internal hemorrhage refusing to perform a blood transfusion stating that his beliefs do not permit it? What would we all say? It has never occurred, although I know doctors who practice such beliefs. But they would simply step aside and ask a colleague to take over.

Same should be true in cases involving pregnancy termination. A woman can refuse an life-saving abortion saying it is against her religion. As long as she is competent to make the decision, the doctor has to abide by her wishes. The doctor, though, can not refuse to perform it because his beliefs do not permit it, in emergency. In emergency, he should step aside and ask a colleague to take over.

And re doctors... Idealistic or not idealistic, as long as abortions are legal, the doctors should be trained to do it in cases of emergency. Their job is to save lives, and if there is the harm to mother's life, they'd better be prepared to do everything to save her. Including abortions.

There are many professions in medicine that do not involve abortions. Neurologists, psychiatrists, dermatologists, ophthalmologists, X-ray specialists, ENT's, what not. But as soon as you have chosen a fiend where emergency termination of pregnancy is a possibility, you have to be prepared to do it.

 

[Circe]

I see a certain double standard in all cases involving termination of pregnancy. Imagine a different situation.

Supposedly, a patient with internal bleeding (not pregnant at all) refuses a life-saving blood transfusion citing some religious beliefs. She is within her rights, it is her choice.

Now imagine a doctor watching a woman dying from internal hemorrhage refusing to perform a blood transfusion stating that his beliefs do not permit it? What would we all say? It has never occurred, although I know doctors who practice such beliefs. But they would simply step aside and ask a colleague to take over.

Same should be true in cases involving pregnancy termination. A woman can refuse an life-saving abortion saying it is against her religion. As long as she is competent to make the decision, the doctor has to abide by her wishes. The doctor, though, can not refuse to perform it because his beliefs do not permit it, in emergency. In emergency, he should step aside and ask a colleague to take over.

Oh, very well put. Agree 100% with this analogy.

 

[Pandora II]

Circe - I to went a-googling over this one and I'm calling hoax on it as well. Too many things don't add up and not a shred of evidence or documentation.

 

[Arkteia]

Ok I decided to tell a story of my second pregnancy... do not know if it belongs here or not. It was not planned, I was on natural progesterone for contraception and like the woman in the story, had no symptoms of pregnancy whatsoever. It happens, maybe progesterone had tio do something with still having periods. We found out when I was 14 weeks pregnant and tphe belly started growing. So with the first US, finding a good obstetrician...15 weeks. Quad test -screening for Down syndrome, spina bifiday and a couple of other things. It came back abnormal..1/100 possibility of trisomy 18. Google it and toe shall see... horrible malformations, no chance of surviving past one year. The baby spends his life tied up to all tubes, deaf, malformed, retarded..obliOvious to everything. GI tube, often colostomy and dialysis is needed... there were blogs posted by several parents. Most of them chose to give birth to the baby, baptize him and then spend nights in the hospitals never even hearing his cry... these babies can not. And then bury the child. Several parents chose to terminate pregnancy.
I go to church but I am a physician...I would never put this baby through misery, my other son through misery, and most of all, my husband who yearned for the second child...
So now we had to do chromosomal analysis. Amniocenthesis with 2% chance of gmiscarriage. I did it. My geneticist calls me...the cells do not grow...they will give it 10 days.
To explain the situation. Elective (and it would be considered elective) abortions are allowed till week 22. I am on week 17...and the window is closing. And the cells do not grow. Week 18. A call. We have to repeat the amino because they did not grow.
And during that amnio, the doctor performing it says "oh, you are one of these 25 moms...that night, there was the power outage and the Dynacare lost all cultures!"

No comment on the idiocy of waiting for 10 days till the dead cells would grow. Now I have to wait again. I call my geneticist. Is there a faster test? For sure, there is a Fish test, it takes two days...the insurance may not approve it and it will be $1k out of your pocket... guy, I do not care I have no time!!! So they did the test. He promised toooppo call me the next day but did not since it was Friday evening so I had to wait till Monday.
So I got both results at the same time. No trisomy. Chromosomally normal male. I had my son on 37th week. I do not know whether it was the result of two amnios or just happened. I have my child and he is Ok. Just thought i should post it here. Things would not be.legal after 22weeks. Sorry for typos. It is my Droid.

 

[allycat0303]

I think this is going to be a really unpopular post, but I really wanted to say something.

First off, I wanted to write that I am a medical resident, so that might bias me.

I am also firmly on the belief that a woman has the right to choose what happens to her body.

However, the article is written in an inflammatory, shock value way. First of all, a physician is allowed to refuse to perform any procedure that he is uncomfortable with. It can not be based on discrimination, racial, sexism, but he is absolutely allowed to perform an abortion based on moral grounds. If he is against it, he does not have to do it. That is his right.

Now did he really, refuse to save her life, even though it was obvious that the fetus was not viable????...that's not the way I would put it. If the fetus was dead, no heartbeat etc. Then the fetus is NOT viable. Everything before that, there is the possibility of viability. The decision of when or when not to operate is dependent on the individual physician, i.e his experience and his judgement. As is the timing of when you should operate. There is no clear indication, and a patient can not possibly make a judgement of whether or not to operate without having the same experience and judgement as that particular physician. In addition, medicine is not cut and dry, the same situation presented to two physicians with the same number of years of experience, may get 2 completely different management strategies! None of which are negligent.

In addition, nothing from the story (i.e the patient could actually answer the medical students questions) indicates that this patient was unstable, or crashing, which would have prompted an immediate transfer to the operating room. Even if the doctor DID perform abortions, it is possible that the patient would have been managed in EXACTLY the same manner, which is watchful waiting, unless she became unstable, at which point she would have been transferred to the OR.

In the majority of cases when the answer is not clear cut, surgeons generally prefer to be conservative and wait for the patient to declare themselves before rushing off to operate.

 

[diamondseeker2006]

Ally,on the contrary, your post should be very popular because it was 100% unbiased but also with the medical knowledge to back it up. Thank you!

 

[galeteia]

Ally,on the contrary, your post should be very popular because it was 100% unbiased but also with the medical knowledge to back it up. Thank you!

Agreed.

One thing that continues to concern me is that fact that the physician failed to confirm that his back-up (should it progress to the emergency procedure) had gotten his message and was aware of the situation.

I understand what you are saying about the signs not being dire (*I* am no medical professional, so I'll readily go with you on this one) but if the doctor and the nurse both told the husband that they might not be able to save her life, doesn't that imply that yeah, things WERE pretty dire?

 

[Black Jade]

Is this the case under discussion?

http://newsbusters.org/blogs/jill-stanek/2011/06/07/salon-abortion-story-conflicts-original

 

[Black Jade]

When I got pregnant with my second child, I had what was called an AFP test. After the results of the test came in, the medical personnel stopped called my baby a baby and began to call him a 'fetus'. They then began extreme pressure on me to 'terminate' the pregnancy because there was some 99% chance that the 'fetus' had a condition, I've forgotten the technical name where he definitely would be born without a brain. When I said I would never 'terminate' the team of doctors (mostly male) held a meeting with my husband, who they felt would 'reasonable' and realize that it made no sense to go through the whole pregnancy only to have the 'fetus' live only a few hours afterwards, giving us great pain and misery, etc.etc. I don't know why my husband was suddenly so important in this--it was 1987 and it was already quite well established that the woman is the only one who has rights over 'her body'.

Anyway, we didn't listen to the drs. We were prepared for our child to born ill and to die, through the whole pregnancy. Fortunately for us, as we thought, he did indeed have a brain. In fact, he has since tested out as a genius. He does happen to be bipolar, as well. But that is certainly not the same thing as not having a brain--nothing on the end of his spinal cord was what I was told, because of the levels of this alpha-feta protein (I may be spelling this wrong).

The kicker to the story is that a few years later, I learned from my brother-in-law, an M.D. who graduated from Cornell U and Hahneman, that the results of that particular test were not well understood in the 80's and having the levels I had does not mean that you have any greater chance of a disabled, brainless (literally) child. So it was not 'fortunate' that the baby was fine, the whole thing was an error from start to finish. I later met one woman (I am sure there must be more) who had terminated a wanted pregnancy because of the same misinformation I had been given.

After me and my husband refused to 'terminate' (I love these disguise words that are used for things like this) one of the drs who had been part of the team sitting frowning at me, the hysterical woman who wouldn't listen to reason, followed us out into the hall and told us privately that he was very glad that we hadn't made that decision (and remember, both he and we still thought that the baby most probably had no brain at that point), but that the practice was forced to advise women the way they had advised me because of 'all the malpractice suits possible if they didn't warn people and then they had defective children.'

It's a little hard for me to think of a sick child as being defective. My brother had cerebral palsy and he was a lot of trouble for my mother and died young (not from cerebral palsy) but she loved him. I suppose my bipolar son is actually 'defective'. I know many people who are raising Down's syndrome children (and I have a cousin who has this) and it is a difficult life but the mothers say it has its rewards. I read recently that these children are essentially not born in countries such as Britain anymore, but routinely screened out and aborted. I do not know that this is actually true, since I read it in the newspapers , when there was the scandal in Britain a couple of years ago where the mother aborted a baby (late-term) because a harelip showed up on the screening, in spite of being told that this is a correctible medical condition. According to the newspaper, the dr. who reported this herself had a harelip which was corrected, as does her brother and so thought this was over the line.

Hitler first sent the handicapped to the extermination centers, way before the Jews and others. Margaret Sanger famously visited him. Has anyone here ever read her writings on the 'science' of eugenics, in which you get to decide who is unfit, including not only handicapped but ethnic minorities such as Italians and southern Europeans--and of course, blacks? My friend who survived two concentration camps and a deathmarch, when she comes to give her talks, tells about how the Jewish women in the ghetto she was trapped in as a young teenage girl were forbidden to have babies and forced to have abortions. She is a religious Jew, which must disqualify her to have an opinion on this, according to the standards of some who are posting, who is very proud of having had children and grandchildren and greatgrandchildren, instead of having been exterminated like most of her family (the photos on her wall of extended family, hers and her husband's) all died in camps, but although she tries very hard to be 'tolerant' on this issue, she always says that it's hard to be neutral after having been through the 'children's selection' in the ghetto where all the children under 14 were carted off and gassed. She likes to be around children most of all, even handicapped; one of the best days we have ever had together we spent at a friends house where there are lots of children, including one who was a near-drowning victim and is now in what they call a 'persistent vegetative state' and is very well cared and is a delight, and where in and out of the house come others with their Down's syndrome children and those who have not only have their own disabled children but have also sometimes adopted children from other countries with severe handicaps by any standard. They all support each other and love their 'defective' kids.

 

[Circe]

Is this the case under discussion?

http://newsbusters.org/blogs/jill-stanek/2011/06/07/salon-abortion-story-conflicts-original

... that website is nutso. It calls her "politicized" for worrying about the probability of unpopular political figures being at risk, and racist for a comment about football via hyperlinks, which I bet works wonders on the folks who don't bother with grains of salt and believe everything they read. "Combating Liberal Media Bias," indeed - more like twisting everything to fit a pre-twisted filter!

ETA: Just figured out the "racist" and "politicized" comment - while wingnut Stanek read closely enough to mark the precise dates of her vaginal bleeding, she somehow missed the fact that Kendall/Karnythia is a black activist who writes a lot about race and gender. Wow, that is some poor reading comprehension right there ....

Regarding both Crasru's post of a few days ago and Black Jade's most recent one, I'm really sorry you ladies had to go through all that. I'm glad you both had the option to make the choices that were right for you.

One thing that continues to concern me is that fact that the physician failed to confirm that his back-up (should it progress to the emergency procedure) had gotten his message and was aware of the situation.

I understand what you are saying about the signs not being dire (*I* am no medical professional, so I'll readily go with you on this one) but if the doctor and the nurse both told the husband that they might not be able to save her life, doesn't that imply that yeah, things WERE pretty dire?

Am also very curious about this ....

 

[allycat0303]

I see this story, not as much as physcian mal-practice, but rather an eample of how poorly physicians communicate with their patients, and how it can be misinterpreted. First of all, I doubt that the nurse called some random physcian who was not on call, from another hospital. If the nurse felt it was being mismanaged she would have called the second physician on call, or she would have notified the chief of service. So there are many holes in this story.

Reading between the lines, I see it as being quite simple.

Mother starts to hemorrage, controlled, stable patient, fetus appears viable
Doctor (who does not do abortions) adopts a watchful waiting, hoping for the best outcome, which is cessation of bleeding and viable fetus.
Bleeding continues
Patient becomes unstable, watchful waiting has failed. Doctor or nurse calls the second or third physician on call
Rushed to the OR, unstable/crashing patient
Mother writes a story about how the physician refused to save her life.

It could easily have gone the other way:

Mother starts to hemorrage, controlled, stable patient, fetus appears viable
Doctor (who does not do abortions) adopts a watchful waiting, hoping for the best outcome, which is cessation of bleeding and viable fetus.
Bleeding continues
Patient remains stable. Bleeding slows down and stops.
Mother is healthy and baby is born healthy
Mother writes a story about how her baby was saved

At the very beginning the physician should have sat down with her, and taken 10 minutes to explain to her what his management strategy would be. That these are the things he was watching for, this was his best outcome and worst case scenario, and what signs he would feel were indications for surgery. I think that would have made the situation much less hectic and confusing for the patient.

I think what's difficult to comprehend, is that patients can be stable and then take a very fast turn for the worst. I've had a patient that was ok, talking, laughing, a little short of breath, but able to walk around. One hour later, she was in flash pulmonary edema, and was intubated emergently on the floor and transferred to the ICU. She ended up being mechanically ventilated for 3 days, even though she had been walking around on the floor 1 hour previously.

Sometimes, surgeons are accused of acting too fast, being too aggressive. When there is another life at stake (a fetus) you tend to be more cautious. It's always a judgement call, and sometimes, the physcian makes the wrong call. But I can't say that with a living fetus and hemorrage, with a STABLE patient, I would rush to the OR and perform an abortion. I would have waited until the patient was crashing, just on the hope that I could save the baby.

And I am staunchly of the opinon that abortion should be legalized, and not just deciminalized in Canada.

 

[princesss]

Thanks for your posts, Ally. I think having a poster like you with experience on the "other side" of a situation like this is really valuable.

 

[Circe]

Thanks for your posts, Ally. I think having a poster like you with experience on the "other side" of a situation like this is really valuable.

Deeply agree - thank you for laying it out for us, Ally. After the many black-and-white news stories I've read about the medical industry, it's an eye-opener to see it from this kind of an objective perspective. Very much appreciate your taking the time.

 

[jstarfireb]

Very, VERY good points, allycat, including ones that I as a fellow resident didn't really think about. Perhaps my staunchly pro-choice views clouded my thoughts on the issue, but I took everything she said at face value. Now that I've read ally's post and thought about it more, I agree with her and believe that's more likely the story of how it went. I doubt any of the behind-the-scenes decisions were communicated to this woman. Physicians as a whole, especially when we're on call in a hospital rather than working in an office, tend to do a very rushed and poor job of communicating information to patients. We communicate just fine with other docs, but when we're so pressed for time and stressed out, we often forget to keep the patient in the loop. It's not an excuse, but just an observation and maybe a reason why this case went the way it did. We may never know what really happened.

This quote is something I can't emphasize enough:

I think what's difficult to comprehend, is that patients can be stable and then take a very fast turn for the worst. I've had a patient that was ok, talking, laughing, a little short of breath, but able to walk around. One hour later, she was in flash pulmonary edema, and was intubated emergently on the floor and transferred to the ICU. She ended up being mechanically ventilated for 3 days, even though she had been walking around on the floor 1 hour previously.

Patients, especially young and previously healthy ones, can go from normal to death's doorstep seemingly in minutes. The disease process that kills or almost kills them was there all along, but the young healthy types can compensate for a while, so they'll have normal vital signs and appear essentially normal...until they reach a point where they can no longer compensate, and they fall fast. It's like dropping off a cliff.

 

[wakingdreams53]

Between awful thing like this and this latest news, this is not a great time to be a woman...
http://thinkprogress.org/justice/2011/06/03/235552/personhood-bills-attack-contraception/

 

[ksinger]

Between awful thing like this and this latest news, this is not a great time to be a woman...
http://thinkprogress.org/justice/2011/06/03/235552/personhood-bills-attack-contraception/

Nothing they'd like more than finally being able to repeal the entire 20th century...

 

[DivaDiamond007]

I see this story, not as much as physcian mal-practice, but rather an eample of how poorly physicians communicate with their patients, and how it can be misinterpreted. First of all, I doubt that the nurse called some random physcian who was not on call, from another hospital. If the nurse felt it was being mismanaged she would have called the second physician on call, or she would have notified the chief of service. So there are many holes in this story.

Reading between the lines, I see it as being quite simple.

Mother starts to hemorrage, controlled, stable patient, fetus appears viable
Doctor (who does not do abortions) adopts a watchful waiting, hoping for the best outcome, which is cessation of bleeding and viable fetus.
Bleeding continues
Patient becomes unstable, watchful waiting has failed. Doctor or nurse calls the second or third physician on call
Rushed to the OR, unstable/crashing patient
Mother writes a story about how the physician refused to save her life.

It could easily have gone the other way:

Mother starts to hemorrage, controlled, stable patient, fetus appears viable
Doctor (who does not do abortions) adopts a watchful waiting, hoping for the best outcome, which is cessation of bleeding and viable fetus.
Bleeding continues
Patient remains stable. Bleeding slows down and stops.
Mother is healthy and baby is born healthy
Mother writes a story about how her baby was saved

At the very beginning the physician should have sat down with her, and taken 10 minutes to explain to her what his management strategy would be. That these are the things he was watching for, this was his best outcome and worst case scenario, and what signs he would feel were indications for surgery. I think that would have made the situation much less hectic and confusing for the patient

I think what's difficult to comprehend, is that patients can be stable and then take a very fast turn for the worst. I've had a patient that was ok, talking, laughing, a little short of breath, but able to walk around. One hour later, she was in flash pulmonary edema, and was intubated emergently on the floor and transferred to the ICU. She ended up being mechanically ventilated for 3 days, even though she had been walking around on the floor 1 hour previously.

Sometimes, surgeons are accused of acting too fast, being too aggressive. When there is another life at stake (a fetus) you tend to be more cautious. It's always a judgement call, and sometimes, the physcian makes the wrong call. But I can't say that with a living fetus and hemorrage, with a STABLE patient, I would rush to the OR and perform an abortion. I would have waited until the patient was crashing, just on the hope that I could save the baby.

And I am staunchly of the opinon that abortion should be legalized, and not just deciminalized in Canada.

The bolded part represents when happened when I had the abruption. It was decided fairly quickly that the only way to save me and my daughter was to do a c-section as soon as possible. The risks were explained and I was whisked off to the OR. As I said before, I am so very grateful for the medical team that treated me. Had my OB not made the judgment call to do the c-section then and there my daughter probably would not have survived.