@vanilla frosting – Yes, bioethics are very frustrating. For me, the question is whether it is ethical for medical staff to allow a pregnant woman in labor to cause severe life-long disabilities (or worse, death) of the fetus in her without trying to intervene? Yes, this case turned out fine (the baby was born healthy), but what it the situation had went the other way? Should medical personnel just let the baby die because a mother doesn’t want treatment?
Here is some more information I found citing the New Jersey appellate court documents.
“[VM]…consented to the administration of intravenous fluids, antibiotics, oxygen, fetal heart rate monitoring, an episiotomy3 and an epidural anesthetic.
She refused to consent to any other invasive treatment, however, including a c-section or fetal scalp stimulation. Hospital personnel explained the potentially dire consequences of not allowing a c-section in the event of fetal distress, but V.M. remained adamant in her refusal.
In the hospital records, V.M. is described as “combative,” “uncooperative,” “erratic,” “noncompliant,” “irrational” and “inappropriate.” She ordered the attending obstetrician, Dr. Shetal Mansuria, to leave the room and told her if she did not do what V.M. said, she would be off the case. V.M. then threatened to report the doctor to the police.
In fact, at one point V.M. did call the Livingston Police to report that she was being abused and denied treatment. She told a nurse that “no one is going to touch my baby.” She continuously refused to wear the face mask that provided her with oxygen and also refused to remain still in order to allow for fetal heart monitoring. She thrashed about to the extent that it was unsafe for the anesthesiologist to administer an epidural. She would not allow Dr. Mansuria to touch the baby or perform an ultrasound examination.
Throughout this entire period, V.M. “was very boisterous and yelling and screaming at the top of her lungs.” B.G. was present while all of these events occurred. Dr. Mansuria explained the complications, such as brain damage, mental retardation and fetal death, that could occur if the fetus went into distress and a c-section was not performed. She also explained that an examination revealed a “nonreassuring fetal status.”
B.G. said that he understood the risks, but V.M. would not consent to the procedure. The hospital responded appropriately to confront V.M.’s mental state and her refusal to consent to the c-section. After considering V.M.’s “extreme behavior” and signs of developing fetal distress, the hospital staff requested an emergency psychiatric evaluation to determine V.M.’s competency.