Birth and Nature
Susan’s case in her state of pregnancy and medical conditions is a good example of the application of clinical ethics. In such cases where the patient lacks the capacity to make a decision, the Ottawa Hospital Obstetric Department, in this instance, makes the decision on behalf of Starlight. The physicians in hospital advised Starlight on what was required for her safety and that of her daughter following her condition of pre-eclampsia. She insisted on the typical delivery on regular time, which she thought would be the best for her and the benefit of her unborn child. Her friends also advised her on pegging to the natural way and prayed with her. Hospital workers without her consent sedated her and performed a caesarian section, which helped Starlight to give birth prematurely and was informed of her baby girl in the neonatal nursery.
In this case, Susan is well informed by the physicians in the Ottawa Hospital Obstetric Department on the dangers of her illness to her and the unborn child. Going against her preferred way of natural delivery, she is hesitant to make the informed decision and decides to depend on prayers for the well-being of her and the unborn child as advised by her friends. Her state of confusion with the will to deliver naturally are evident and deny her the capacity for decision-making.
The caregivers, in this case, had enough reason to doubt the decision-making capacity of Starlight. Despite going to seek professional advice in hospital on her health and that of the baby, she did not consider the possibility that they were both in danger of death together with her unborn child. The medical staff knew that Starlight condition was in control, both Starlight and her child were not endangered if she was induced and delivered a little earlier than usual and the harm of not taking these precautions. To save both Starlight and her unborn child from the danger, they sedated Starlight and performed a caesarian section.
Starlight discharging herself after two days could cause her great danger, as she had not healed the wounds. Leaving the daughter in the hospital and without the staff awareness clearly shows her impaired decision-making. Though the doctor who ordered Starlight sedated was familiar with her preferred preference to refuse the induced delivery, he/she went ahead and ordered her to deliver. They were confident that the process would work correctly for the patient with the condition without Starlight and her child getting in danger. With limited time, discharging the patient to look for a different precedent was fatal to the doctor.
From the point of view of an ethics consultant, valuation on Starlight’s capacity decision-making was not thorough since they did not an enquiry for an official decision maker if she was unable to make the right decision. The doctors decision was, however, right in the situation that no enough time was available for consulting bearing in mind the patient preference for a normal delivery. If the doctor were wrong on the first decision in believing that Starlight was incapable of making the right decision, he would take responsibility for the consequences. However, Starlight discharging herself without the consent of the doctor and leaving the child confirms her inability for decision-making. Starlight should follow the legal procedures to get back her baby girl. For her negligence, then the doctors’ decision is justified.
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