Friday, April 9, 2010


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....


Anonymous said...

I don't agree with doctors or other health care workers being allowed to refuse to participate in abortions. If abortion is a constitutional right, then I think medical workers should put aside their personal beliefs and provde the medical care. I am very concerned that in 10 or 15 years there will be few places in our country where abortions are available and poor women won't have the means to travel to them and pay the cost. Even today the $500 is a huge hurdle for the working poor.

Clive 5impkins said...

Totally agree with you, Doc. Old Hindu proverb: If you give a glass of water to the man taking a cow to slaughter, you participate in the slaughter. Abortion in exceptional circumstances yes. But contraception *first and foremost*. We're talking about taking a life at an early stage. I empathise deeply with your concerns.

Neil said...

Evacuate... the room!
We could go on and on about our liberal constitution and freedom of choice and we could miss the wood for the trees. Abortion is MURDER!
The pro-choice lobby and the planned parenthood agenda constantly resort to illogical rhetoric, none of which is based upon an absolute standard. If everything is relative, and up to the individual, then kids with Down's syndrome, or the cerebral palsied, or geriatrics that are bed-ridden better hide, because someone may decide that they are an inconvenience, or not economically active and could just be disposed of.
All humans, no matter how small, were created in the image of God and therefore inherently possess dignity that must be preserved. There's an absolute to stand on! Nevermind the 6th commandment.

Bongi said...

as far as doing things that are permitted by the government, the nazis used doctors against jews. it was legal to kill them, never mind using them for unethical medical experiments. in the apartheid regime, doctors were also used to classify race. it was the law. quite soon in south africa, it may be legal to kill whites. doctors may once more be used.

i do not think doctors should do what is considered right by lawyers and politicians if their consciences don't agree with it. in general i think if you are using lawyers and politicians to determine what is right, i think it is a very very sad state of affairs.

VIVA TIVA said...

I have been caught this way soooo many times!! The case simply gets booked as a D & C, and only once the suction comes out is the truth revealed. Damn sneaky if you ask me. I now refuse to dope all D & C's that are not specifically booked as DIAGNOSTIC.

Mike Blackburn said...

@VIVA - it is a difficult situation. Problem is that they are often booked as emergencies - and it is difficult to refuse, especially out in the private sector. I guess one needs to ask more questions... or take your stand.

Amanzi Down Under said...

I had a D&C booked and only when I read the notes did I see it was indeed an abortion on request. I politely informed the boss/super that I prefer not to be involved. He then had to organise another anaesthetist post haste.

I am now seen as the judgmental, holier-than-thou, lazy doctor only looking out for his own soul.

Wreckless Euroafrican said...

I have my personal views as well. In your case, you must have the choice to proceed, or not. Just as the patient has a right, so do you. A difficult one I know, but I have more than once stood by my morals / choice, and not always been popular for it. Fortunately, it's never been in a situation where life is involved - keep up the good work, and the writing!

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