One of the problems with being the anaesthetist is that often, I don’t know the whole story. Sometimes it is better this way, other times not.
Recently, I was asked to dope a young lady for an evacuation of the uterus. This usually involves curetting/scraping the uterus in order to clean out anything left after a miscarriage. So I go and see this 21 year old woman who is sitting with her fiance. We chat, I ascertain that yes, she is in fact the healthy specimen I was told about, and we whisk her off to theatre. I assume my sympathetic role, poor girl, she’s had a miscarriage etc..
As I am putting the monitors on, the scrub sister starts talking to the patient and asking about how many weeks she was, and the patient answers that she is 4 weeks pregnant. Now a little light starts flashing in the back of my head. She hasn’t had a miscarriage at all. (miscarriages tend to present later..) On further enquiry by the nurses, it appears that her wedding is in 2 weeks, and she isn’t ready to have kids yet. So now, I am doping for an abortion, and not an evacuation.
Is there a difference? From a technique point of view, no. From a personal point of view, yes. Would I have agreed to dope her if I knew it was an abortion? I don’t know. But I was uncomfortable that this decision was taken away from me. Personally, I disagree with the concept of abortion, and I am given rights in our constitution to reasonably refuse to be involved in that which I do not agree with. Please don’t get me wrong. I am not judging the patient. She too has the right to do what she wishes, and we are obliged to facilitate that. So my rights gave way to hers and we cracked on with the case....
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