Informed Consent is defined as the act of agreeing to a medical procedure, taking into account the benefits and risks of doing said procedure. It is up to you to KNOW, UNDERSTAND and DISCERN what is in your best interest. Informed consent is a patient’s right to be presented with sufficient information, by either the physician or their representative, to allow the patient to make an informed decision regarding whether or not to consent to a treatment or procedure. Patients generally are recognized as having the right to refuse medical care for any reason. Their reasons may include any personal grounds they choose, even if the physician considers their grounds to be frivolous or in poor judgment. In order to ensure that you are in a position to make an informed decision you should meet four requirements:
- your competence and reasonableness (you are not under undue influence)
- full disclosure has been given to you (risks, benefits, alternatives)
- you comprehended the information given to you (can you explain it in turn?)
- you are voluntarily giving consent based on all of the information you have been given
Informed refusal is defined as once a procedure has been explained with all the benefits and risks, consequences for NOT doing said procedure and you understand and accept these risks knowing that an adverse outcome is possible, if not likely, and choosing NOT to have the procedure.
Against medical advice is defined as a person checking themselves out of a hospital early or refusing admittance against the advice of their physician. Such persons are usually asked to sign a form that they are aware that they are leaving or refusing against their physician’s advice. The term AMA is usually noted on the hospital’s report and said person should be aware that their insurance may not cover any subsequent care or charges as a result of their decision. When the issue is about whether you choose to undergo a procedure against your judgement and therefore absolutely put yourself at risk for which the physician will not be held accountable for OR you are not in the economic position to refuse and bear the financial burden you are under duress and should not be engaging in this agreement!
Understanding the roots of informed consent and recognizing the physician who is paternalistic in the interpreting of informed consent affects your ability to exercise your patient rights to the fullest extent protected by law. Learn about your health and patient rights in order to have dialogue with your careprovider that gives you REAL answers to your questions about birth care options and your ability to identify and bring to fruition those birth choices that are a priority to you.
Laborist noun; from Louis Weinstein, Thomas Jefferson University Hospital 1. (employment for Generation X and Y): depending on the hospital for one’s livelihood ~ income or resources 2. ( individual): doctors who work full time in the hospital, do only labor and delivery and work shifts of no more than 12 hours (from Arnold Cohen, Albert Einstein Medical Center): specialization, predictability
There’s a new doc in town. But mom probably won’t meet this obstetrician until her labor pains start.
This article poses Generation X and Y as the fall people for the economics of maternity care being in need of enhancement. If we are to believe this then we are to blame this same generation for assembly-line birth (start at induction and end your flow chart at episitiomy+forceps/vacuum or cesarean), obstetricians requiring a greater number of births in order to bill for and be able to pay for malpractice insurance (whether for poor use of interventions or mistakes made by lack of sleep) and office overhead costs and the dehumanization of birth.
Those are some heavy charges to lodge against these young people, and on behalf of the many young and older parents who have come through our birth classes we feel a need to set the record straight. Parents are searching for “care” providers. Knowledgeable, skilled and normal-birth experienced men and women who still hold a baby’s first seconds and moments in our world as being wondrous, joyful and sacred.
Parents are searching for men and women who refuse to work robotically, pushing crowds of women down a birth chute without names, identities or beliefs. Parents, who while appreciating the conveniences of technology for things such as researching information, have never stopped believing that healthcare should consist of nurturing the whole body and preserving whole health with invasive procedures as a final option. America may not rank up there with Cuba and other countries with better maternal and infant mortality outcomes but we do not believe that Americans or parents around the world prefer medical birth to normal, human birth.
The Midwives Model of Care™, defined by the Midwifery Task Force, is alive and well, although if journalistic pieces such as Division of Labor continue to make it through the editorial process it may be harder for the public to learn about it (and some might argue that the dehumanization of birth will continue to rise as a fault of the media’s integrity).
Under the Midwives Model of Care™, which is “based on the fact that pregnancy and birth are normal life processes”, quality birth care includes:
- Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
- Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
- Minimizing technological interventions
- Identifying and referring women who require obstetrical attention “The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.”
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