Medical Ethics in O&G

1. Medical Ethics in O&G Dr. Anna Stienen-Durand ST3 O&G, RSCH 29.9.14

2. Medical Ethics Until Now…. • Informed consent • Capacity • Confidentiality • Clinical negligence

3. Medical Ethics in O&G • Death and stillbirth certification • Termination of pregnancy

4. Death and Stillbirth Certification • Stillbirth or neonatal death • Maternal death • Death occurring on the gynaecology wards

5. Reporting a Death to the Coroner • Maternal death after TOP or miscarriage • After an operation • Child born alive at any stage of pregnancy and then died

6. Post Mortem • Provide significant information about cause of death in 60-80% of cases • Provide information for future pregnancies • Complete/limited/external post mortem • Tissue samples

7. Termination of Pregnancy • HSA1 form • Medical TOP • Surgical TOP

8. Conscientious Objection • Doctors may refuse to participate in terminations but are obliged to provide necessary treatment in an emergency when the woman's life may be jeopardised • Doctors with a conscientious objection may not impose their views on others but may explain their views to a woman if invited to do so • Refusal to participate in paperwork or administration connected with abortion procedures lies outside the terms of the conscientious objection clause • Practitioners cannot claim exemption from giving advice or performing the preparatory steps to arrange an abortion where the request meets the legal requirements. Have a duty of care to refer a woman requesting a TOP onwards. • The clause may be used by medical students to opt out of witnessing abortions

9. Useful Information • ‘Deciding on a post mortem examination-Information for parents’ SANDS • The Care of Women Requesting Induced Abortion • Evidence based clinical guideline number 7, RCOG • Department of Health website • StratOG learning modules • Trust protocols

10. Summary • Stillbirth certification • Reporting cases to the coroner • Post mortem • Termination of pregnancy • Conscientious objection to TOP