"All that is necessary for the triumph of evil is for good men to do nothing" Edmund Burke, 18th century Philospher.

"A long habit of not thinking a thing wrong gives it a superficial appearance of it being right." Thomas Paine

"The welfare of humanity is always the alibi of tyrants." Albert Camus

"Choice is the essence of ethics: if there were no choice there would be no ethics, no good, no evil; good and evil have meaning only insofar as man is free to choose." Margaret Thatcher, March 14, 1977

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” ― Upton Sinclair

Explaining the Cause

I am a practicing obstetrician who is a strong supporter of patients rights to informed consent and refusal. I believe a patient has the right to choose her own path given true and not skewed informed consent. Following that tenet, just as a woman should be able to choose to have an elective c/section she should be able to choose not to have one, as well. The American system of hospital based obstetric practice has been eroding those choices for women for quite some time. Due to concerns of economics, expediency and fears of litigation women are being coerced to make choices that may not be in their best interest.

I have had a long relationship collaborating with midwives and find the midwifery model of care to be evidenced based and successful. I was well trained at Cedars-Sinai Medical Center in the mid 80's to perform breech deliveries, twin deliveries, operative vaginal deliveries and VBACs, and despite evidence supporting their continued value, hospitals are "banning" these options. Organized medicine is also doing its best to restrict the availability of access to midwives.

Home birthing is not for everyone but informed choice is. Medical ethics dictates that doctors have a responsibility and a fiduciary duty to their patients to provide true, not skewed, informed consent and to respect patient autonomy in decision making. Countries with the best outcomes in birthing have collaboration between doctors and midwives. This is not what has been happening in the hospitals of America. Its time for a change and the return of common sense.

The midwifery model of care supports pregnancy as a normal function of the female body and gives a legitimate and reasonable alternative to the over-medicalized model of birth that dominates our culture. Through this blog I hope to do my part to illuminate what is wrong with our maternity care system and what is right with it. I do not expect all to agree and that is OK. We must all understand that given honest data it is not always reasonable to expect two people to come to the same conclusion. Our differences should be respected.

Sunday, November 8, 2009

AARP and the House Bill

Those of you who know me know that I am fervently against the house bill on "health care reform" that apparently passed yesterday. This abomination of a piece of mutating legislation that no one has read and no one understands has been called by the Wall Street Journal editorial page as "one of the worst pieces of legislation in American history". If you are not well informed on this issue please consider checking out www.docs4patientcare.org and soon because it will negatively alter the basic nature of America . For the determination of Congress and the President to just do something, no matter if it makes no sense, is cost prohibitive, destructive to patient care and decried by the majority of Americans, should be frightening and maddening to all of us.

For AARP (the American Association of Retired Persons)to publically endorse this bill is baffling. Almost all experts agree this bill will hurt the elderly. So why would they endorse anything at this time. Why not wait until it has been reviewed, critiqued and examined by the CBO and the public? Why would they endorse a bill that is still changing and no one understands? Some claim that AARP has an economic interest in the billions from insurance policies they sell and that this piece of legislation will benefit them. Whatever the reason, their decison to endorse is premature and seems to throw their constituents under the bus. I called and had a cordial conversation with a representative of AARP. She had no answer for the question of "why now?". I told her that because they could not explain their position I could no longer support AARP and would not be renewing my membership. I would encourage you to call and ask questions for yourself.

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