Doctor must not postpone information about caesarean section

Doctor must not postpone information about caesarean section

We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

BGH: Expectant mother must be able to decide on treatment

If there are specific indications of an impending problem birth, pregnant women must be informed about a caesarean section as an alternative treatment at an early stage. If the clarification only takes place if only a "hasty caesarean section" is considered, this basically represents a treatment error for which doctors and clinics can be liable, the Federal Court of Justice (BGH) in Karlsruhe decided in a published on Monday, November 12, 2018 Judgment (Az .: VI ZR 509/17).

The final lawsuit concerned a child born on November 23, 2006 with brain damage. The mother had previously presented with regular contractions in the clinic in Schleswig-Holstein. However, after the woman received contraceptive pills, the child's heart rate dropped several times. The third time, the attending doctor found that the cervix had not yet opened. She ordered a so-called "urgent caesarean section" and informed the expectant mother about the necessary treatment.

In the case of an "urgent Caesarean section", the child should be delivered within 30 minutes at the latest from the time of the decision about the Caesarean section. The information provided to pregnant women is relatively scarce given the urgency. With an emergency caesarean section, on the other hand, the birth should take place within 20 minutes. The information about the procedure that is always performed under general anesthesia is then minimal.

In the specific case, the pregnant woman panicked about the upcoming "urgent caesarean section". She refused a urinary catheter and refused oxygen through a nasogastric tube. She also did not want to take a sedative “to improve cooperation”. The daughter was finally born twelve minutes after the 30-minute deadline for "urgent Caesarean sections".

The mother attributed the brain damage to her child to the late Caesarean section. In addition, she was not informed in good time about the advantages and disadvantages of the Caesarean section. This means that she was not able to freely decide on the individual delivery methods. The fact that she was only cleared up with the order of the "urgent Caesarean section" had led to a delay in delivery.

In its judgment of August 28, 2018, the BGH stated that, in the case of a normal birth, no information about a caesarean section is required. If there are concrete signs of a problem birth, the doctor must provide early information about a caesarean section as an alternative treatment. If he does not clarify this in good time, liability can be considered. The pregnant woman had to be able to choose between different delivery methods and their risks as well as their advantages and disadvantages. This gives the expectant mother the right to self-determination.

Here, precautionary information about the caesarean section as an alternative treatment should have been given at the latest when the child had a bad heart rate for the second and not the third time.

The pregnant woman was only informed when an "urgent caesarean section" was necessary. At this point in time there was no alternative treatment, the BGH complained. If the failure to provide timely information leads to a delay in childbirth, liability of the doctors should be considered.

The Higher Regional Court (OLG) of Schleswig should therefore now examine to what extent the necessary information has led to the 30-minute period being exceeded and to what extent this can be attributed to an accusingly uncooperative behavior of the pregnant woman. If there is at least one complicity in the clinic, the mother must prove that the deadline has led to birth defects.

According to established case law, there is a so-called reversal of the burden of proof and the clinic is therefore only obliged to provide evidence in the event of gross treatment errors. The BGH had never seen one of these before.

Similarly, the BGH had decided on the duty to provide information on a caesarean section on October 28, 2014 (file number: VI ZR 125/13; JurAgentur notification of February 16, 2015). Thereafter, doctors must inform the patient about the risks, advantages and disadvantages of the procedure at an early stage in the "serious possibility" of a caesarean section. If the danger situation is then clearly exacerbated, appropriate information is required, but not a new explanation.

In a judgment of May 17, 2011, the Karlsruhe judges emphasized that a caesarean section should not be given until the child is at risk (Az .: VI ZR 69/10; JurAgentur announcement from July 1, 2011 ). The expectant mother should not be burdened with possible dangers and risks of the various delivery methods without reason during the birth process. If a caesarean section is considered due to specific information, the expectant mother must be informed about it. fle / mwo

Author and source information

Video: C Section Cesarean Delivery Video by Dr. Annadate Stating Reasons for Cearean Birth. Why Cesarean? (November 2022).