OB clinical - Page 2

[mum2row]

Originally Posted by Contented73

I don't know, if everyone is so anti-circ, why aren't more health care professionals refusing to perform or assist with circs? It amazes me when I hear all these nurses or midwives and even OBs whispering behind the scenes how awful they think it is, yet they march right in and help the babies get circed anyway.

They are not refusing for one big reason. It is not their decision to make. It is the patient (parent's) decision to make. It is important for the healthcare professional to ensure that the parents are informed so they can make the decision that is appropriate for themselves.
Until circ is no longer acceptable (which education can help change) health professionals have to respect their client's choices.
OP, like has already been mentioned it is important as a nurse to remember that people need to and are capable of making their own decisions. It is your responsibility to provide information and respect THEIR decision.

[Quirky]

I totally disagree that it is the parent's decision to make and that healthcare professionals should therefore perform circumcisions without regard to their own opinions. I believe it is a total breach of medical ethics that doctors continue to perform circumcisions in the absence of a demonstrated medical need for THIS baby to have THIS surgery.

There is no single other body part that doctors amputate on parental demand without any medical indication whatsoever.

I mean, I suffered through recurrent bouts of tonsillitis my entire childhood until I finally had my tonsils removed in college. Not a single infection since then.

Should my history of repeated, painful infections give me the right to demand that my children's tonsils be removed at a very young age, despite the fact that they've not yet had a single infection? Or what about the fact that I prefer the way my throat looks without those nasty, swollen, pitted, disgusting tonsils sticking out, clearly visible if I laughed really big?

After all, it's very easy to live a long and healthy life without tonsils. Heck, it's not that long ago that routine tonsillectomy was completely normal and accepted no matter whether kids had had problems or not.

There's no law against routine, unnecessary tonsillectomies. They didn't stop because parents got educated and said, no, enough already, I'm not getting my healthy child's tonsils out.

They stopped because doctors finally refused to stop doing them because the surgery was completely unnecessary and did more harm than good.

So if no doctor in his or her right mind will perform a tonsillectomy on my children without demonstrated cause, why shouldn't a doctor be able to say to parents -- no, this is not medically necessary and I refuse to do it?

The baby is the patient, and the baby's interests must come first in any body-altering surgery. Parental choice is simply irrelevant, because parents shouldn't have the right to have ANY surgery performed on their babies unless that surgery is medically necessary. That is what the issue of proxy consent is all about.

[mama24-7]

Originally Posted by mum2row

They are not refusing for one big reason. It is not their decision to make. It is the patient (parent's) decision to make. It is important for the healthcare professional to ensure that the parents are informed so they can make the decision that is appropriate for themselves.
Until circ is no longer acceptable (which education can help change) health professionals have to respect their client's choices.
OP, like has already been mentioned it is important as a nurse to remember that people need to and are capable of making their own decisions. It is your responsibility to provide information and respect THEIR decision.

but the child is the "client," not the parents. circ is no more a parental decision then what career the child pursues when they're an adult. yet another myth perpetuated by some health care "professionals."

sus

[dannomac]

mum2row, it is interesting that you say that it's the parents' decision. I see that you're in Canada. Did you know the the College of Physicians and Surgeons of Saskatchewan has come out and said that circumcision is a legal grey area, and the Saskatoon Health Region doesn't do neonatal circumcisions anymore? Progress is being made.

[becca_howell]

GL, and I look forward to reading your paper!

[calngavinsmom]

Originally Posted by chelle.ra

i would argue the real issue is that there is not enough unbiased education about one's choices when having a baby in the hospital - the status quo is expected, one might get a pamphlet on the "'other: option(s). it's not really a matter of "choice" if one is not give options with supporting FACTS.

having medical professional REFUSE to do procedures that people have the RIGHT to do is not an option i would like to see. keep your personal opinions at home, and educate yourself and your patients with the best information available, and soon enough people will make the "right" choice.

You might not like to see it, but the option to refuse is already in place. Doctors have a right to refuse to any procedure they find to be unethical. In fact three of our provinces medical authorities are actively encouraging doctors to refuse to circumcise baby boys on the grounds of circumcision being unethical and inappropriate. Check it out.

http://www.circumstitions.com/Sask.html

It is even found in the CPS position statement that many Peds will no longer preform circumcisions.

http://www.caringforkids.cps.ca/preg...rcumcision.htm

And on a personal note, I live in Ontario and when my second son was born, the ped on call asked if we were looking to circumcise and when we declined, she stated "Good. I refuse to do them and you would have to find yourself another physician."

I think it's great that these docs are finding their moral compass and sticking up for their real patients, the baby boys rather than just trying to keep their parents happy.

take care,

[jenP]

Originally Posted by chelle.ra

having medical professional REFUSE to do procedures that people have the RIGHT to do is not an option i would like to see.

But according to medical ethics, parents do NOT have a right to have a healthy baby boy circumcised.
In order for a parent to have the right to choose this procedure, there would have to be clear pathology present, for which more conservative measures had been tried without success, leaving surgery the only option for treatment. Also, the condition would need to be urgent enough that the surgery would need to be done soon (i.e. it could not be put off until the boy was old enough to make informed consent himself therefore his parents would have to make the choice for him now.)

These are the medical ethics under which doctors and hospitals supposedly operate. They have been ignoring their own stated ethics for years in permitting circumcision of newborns for "cultural" or "cosmetic" reasons. Just because doctors have been performing this procedure in direct opposition to medical ethics for years, does NOT translate into parents ACTUALLY having a right to have this done to their sons. They have no more right to cut bits off a healthy boy than off a healthy girl. Try asking your doctor to do a little labioplasty on your baby girl. They will refuse, because it is against medical ethics. You have the right to have labioplasty on yourself, and even if you are very happy with your surgery and love the way it looks and want your daughter to look like you, you won't find a doctor willing to do it. Would you argue that they should leave their personal opinions at home, give you information, and then, if you as the parent still wish the procedure done on your baby daughter, you think the doctor should just DO IT ANYWAY??

No, absent any pathology that requires treatment, parents do NOT have a "right" to have permanent amputative surgery done on their children.

Jen

[Eeyore35]

Originally Posted by mama24-7

but the child is the "client," not the parents. circ is no more a parental decision then what career the child pursues when they're an adult. yet another myth perpetuated by some health care "professionals."

sus

I'm not arguing on whether it SHOULD be the parents' decision, but, yeah, as it stand now, it IS.

I don't have a probem with dr.'s refusing to do it. I found out during prenatal classes that no dr.'s in my town will do it. They weren't sure how far I'd have to travel to get it done. And we'd have to pay for it,not covered by our provincial health plan. My doctor never brought it up. I had a girl, but I didn't find out ahead of time, and I was surprised my doctor never asked. I wasn't planning to get it done, so I never brought it up.

[Smokering]

having medical professional REFUSE to do procedures that people have the RIGHT to do is not an option i would like to see.

And having medical professionals FORCED to perform procedures they find morally abhorrent, whether or not it is the patient's right or his parent's, isn't an option I'd like to see either. Yikes.