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Suit: Staten Island hospital had secret C-section consent policy

A Brooklyn woman has sued Staten Island University Hospital (SIUH), claiming that the hospital has a secret policy reserving the right to overrule women's decisions about getting C-sections. She claims that she wanted a natural birth and begged for more time, but her doctor decided on a C-section despite her lack of consent for the procedure.

The policy, which is outlined in an article in the Guardian, allows SIUH doctors to overrule a mother's lack of consent when they determine there is a "reasonable possibility of significant benefit" for the fetus that "outweigh[s] the possible risks to the woman."

Such a policy runs contrary to ethics guidelines issued by the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP). Both condemn the idea of performing procedures for the benefit of a fetus without the mother's consent.

The practice likely also constituted a criminal assault upon the mother.

"Pregnancy is not an exception to the principle that a decisionally capable patient has the right to refuse treatment, even treatment needed to maintain life," the ACOG said last year. The ACOG and AAP both said in 2014 that "even the strongest evidence for fetal benefit would not be sufficient ethically to ever override a pregnant woman's decision to forgo fetal treatment."

SIUH does not deny that it forced the Brooklyn woman to have an unwanted C-section -- an experience she found "frightening and degrading." Instead, it claims that the procedure probably saved the newborn's life. A note by the head of obstetrics in the woman's chart reads that "The probable benefits of C-section significantly outweigh the possible risk to the woman ... I have decided to override her refusal to have a C-section."

Public records requests by the Guardian to several of the nation's largest hospitals found a number that had no policy about what to do when a doctor and birthing mother disagree about treatment. Those few that did have a policy did not grant the doctor the complete authority to overrule the mother, however.

We recommend reading the entire Guardian article, which discusses a variety of issues surrounding the lawsuit and C-sections in the U.S. The SIUH policy, however, shows one way in which the medical establishment has attempted to resolve the question of what to do when a doctor believes a certain treatment is necessary in order to prevent a birth injury but the mother remains unconvinced. By law, however, patients must always have the final say on what procedures are performed on them.

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