Yet another ruling is providing legal support for the false belief that obstetricians are infallible and stripping pregnant women of basic civil rights that are then accorded to other individuals. In the case, New Jersey Division of Youth and Family Services v. V.M. and B.G., the New Jersey appellate court found that V.M. and B.G. had abused and neglected their child, based on the fact that the mother, V.M., refused to consent to a cesarean section and behaved erratically while in labor. The mother gave birth vaginally without incident, and the baby was "in good medical condition." Then she was never returned to her parents, and the judge in the case approved a plan to terminate their parental rights and give custody of the child to foster parents. What, beyond the obvious, is wrong with this picture?
First, from a legal perspective, individuals have a right to informed consent and bodily integrity. In obstetrics, informed consent is a blurry concept since many hospitals perform obstetric procedures on laboring women without informing them of the evidence concerning those procedures or their risks. Perhaps this legal case illustrates how paternalistic hospitals can be with respect to pregnant women -- assuming that the hospital staff know best and that informed consent is unnecessary. Never mind that hospitals tend to be run with organizational efficiency, rather than patient interests, in mind. In this specific case, one obstetrician who tried to convince the mother to consent to a c-section concluded that she was not psychotic and had the capacity for informed consent with regard to the c-section. It is clear within the law there is no informed consent without informed refusal, so this obstetrician's conclusion should have made V.M.'s refusal to consent to the c-section her decision alone. If this mother is not legally permitted to refuse major abdominal surgery, then she is clearly stripped of her civil rights to informed consent.
In fact, individuals are not legally required to consent to invasive procedures even to save other individuals, including fetuses that lack full legal status. But in this case the district and appellate courts subverted a pregnant woman's informed medical decision-making in the name of fetal rights, arguing that her refusal was a form of abuse and neglect of the child that had not yet been born. This is another dangerous precedent, along with other court-ordered cesarean cases, that will allow all pregnant women to lose their rights to bodily integrity and informed consent. It may be understandable, if not excusable, that the courts don't understand medicine or recognize that medical judgment is fallible, but it is hard to understand how they could so fundamentally misinterpret the law, in which performing surgery on an individual without that person's permission can constitute criminal "battery" under common law.
The court's opinion also suggests that lawmakers have no concept of what it is like to be in labor. Women in labor tend to find themselves on a different mental plane, where they have to focus inward and work with their bodies to give birth. As midwives know, some women become belligerent. Some seek privacy and seclusion. Most women in labor are likely to find the routine and usually unnecessary procedures of hospitals to be invasive and unwelcome. Yet the courts that decided this case didn't seem to be aware that women are unlikely to behave the same way when they are in labor as when they aren't. The decision cites hospital records that describe the mother, V.M., as "combative," "uncooperative," "erratic," "noncompliant," "irrational" and "inappropriate." Also, her husband indicated that the way she was acting was not her "normal manner and that she is not as 'tranquil.'" Why would anyone expect a woman in labor to be compliant, tranquil, or rational? What kinds of expectations does our society have for women undergoing a powerful physiological process, often with an absurd amount of poking, prodding and general interference? This mother was uncooperative with hospital staff, but clearly her uncooperativeness had nothing to do with the well-being of her baby. There is no reason to believe that she did not have the well-being her baby as her top priority, even though she was not a model patient. There is also no reason to believe that everything the hospital staff wanted to do was essential or even beneficial for the well-being of either mother or baby. In fact, typical obstetric care engages in many procedures that are unnecessary and often harmful, more out of habit and for the convenience of hospital staff than in the best interest of patients.
While the court opinion also focuses on the parents' psychiatric diagnoses (which are fallible medical judgments) and their history of care in determining their fitness as parents and abrogating their parental rights, their psychiatric state would never have been questioned if the mother had not refused invasive abdominal surgery -- which was entirely within her rights. The tragic consequence for this family was separation from their infant daughter from the moment of her otherwise uneventful vaginal birth. That kind of injustice can't have been good for the psyche.
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You argue that a woman should be allowed to refuse invasive medical procedures (btw, I completely agree). However, your article is premised upon a case where a "New Jersey appellate court found that V.M. and B.G. had abused and neglected their child, based on the fact that the mother, V.M., refused to consent to a cesarean section."
This is completely false. The three appellate judges expressly stated that they DID NOT consider the mother's refusal to consent to a c-section in reaching their decision.
In fact, one of judges wrote a long argument explaining why he believed the law prohibited him from considerin
If anything, this case supports a woman's right to refuse invasive medical procedures
Apparently it is easier to fan the flames of hatred against the pro-life crowd by claiming that a NJ court has limited a women's right to make decisions regarding the birth of her child. Apparently it doesn't matter if you have to lie about what actually occurred in the case.
You have done serious damage to your credibilit
The moral to the story is :
Be rich, white, don't seek help and stay home to have your baby.
If you decide you want to go to the hospital for childbirth
If you don't, your newborn just might be kidnapped by CPS and given to someone else.
after all, don't you uppity women know the government and men know what's good fer ya!
http://www
_childbirt
be sure to read the comments, too...
Apparently unlike you, I read the court findings and here's what they reveal:. The mother presented with some risk being 42 years old, and baby was in distress. The mother refused O2, refused the fetal heart monitor and was thrashing about so much so that the epidural [which she requested] could not be administer
BOTH parents claimed the mother had never received psychiatri
The father has refused to interact with DYFS, to get the assessment
The court docs read that Dr. Mansuria testified that an examinatio
However, you believe that the doctor was ACTUALLY just trying to get the baby out in the "safest and least chaotic way" because the patient was, what, behaving too wildly? Did you see that the baby was born safely without incident? She was healthy. V was not subjected to unnecessar
Your scenario proposes that it is ok for health care profession
lcrown: "In fact, she was being evaluated by a hospital psychiatri
You say you read the findings. You probably saw that V had already had a psych consult during labor and was found to be competent! She was on the SECOND psych consult (because they apparently didn't like the first opinion) when she gave birth normally.
You don't think that a woman refusing O2 and refusing fetal heart monitoring while thrashing about when it was determined that the baby was already in distress is sufficient for doctors to decide to "ACTUALLY" try and deliver the baby in the safest and least chaotic way???? I do. I mean, please, put yourself in the position of the delivery room staff. A woman who has a long history of psychiatri
They took the baby away bc they couldn't determine the competancy of the family, not because she refused a c-section, and if YOU read the court transcript
.Playing on the fear of women, this blog is even more exploitati
The issue is the controvers
Is the high rate of c-sections an indication of an exploitati
This blog was devious and inflammato
And if we don't agree with them, we're called mentally ill and punished.
Incredibly sad and incredibly wrong. Morally and ethically wrong. Why are doctor's allowed to continue this assault on women? Both OB's and Psyc docs? So often, the trauma of labor is seen as a mental illness.
I'd like to see one of those doctors, lawyers or judges (all men) try and push an 8 pound object out a hole the size of a golf ball and not make some noise and maybe even not make total sense to everyone around. (trying to be as delicate as possible and still make my point.)
women have always been deemed mentally ill (in that they are not men)...or at the very least hysterical (root word hyster = womb)...it seems thought that after a few decades of women taking back child birth (at least to some degree) the pendulum is swinging back in favor of the hospitals and doctors (who, ironically
Actually, the mother in this case was called mentally ill due to her 15 years or so of psychiatri
Full court doc (in html, not pdf) posted on July 20)
http://www
A summary of the court doc with and excerpt from a woman who knows V.M. and blogged about it first:
http://www
The diametric opposition of the "expert" opinions in this case:
http://www
I'm also still perplexed by how many people see this as an example of the legal system doing a great job and not related at all to the refusal of a cesarean. In fact, Louise has been accused (me, too) of being misleading in saying so because the appellate court said that the previous trial judge shouldn't have factored it into his decision.
It seems to me that some people have a very strong need to believe that the system works. Doctors don't push unnecessar
This decision AGREES with the fact that the woman said no to the c-section shouldn't have had an affect on whether or not the child was taken away.
The parents didn't show up for the first court date-- which was before the child was released from the hospital-- despite being called to remind them.
When the parents did show up, the judge set out what the father would have to do to get custody back, even setting a reunificat
The parents lied on several occasions to the court.
Now, I'm not sure if I think the child should have been PERMANENTL
The court appointed "third party" lead the court to find "(1) '[i]t [was] not and will not be safe to return [J.M.G.] home in the foreseeabl
He wasn't unfit, abusive or neglectful but in denial of his partner's supposed mental illness. That is grounds for permanentl
Also VM did not exactly "[kick] her doctor out of the room, and then [call] the police saying she was being denied care." Slight, but important difference
"She ordered the attending obstetrici
Her rights were being violated. She was about to be assaulted and she was being denied the treatment she was legally within her rights to have. It was an emergent situation in which she did not have time to call a lwayer and let the court hash it out.
... How do you know she was about to be assaulted? I'll grant you that I extrapolat
Anyway, the fact that while the father clearly doesn't seem to have his act together in the eyes of the court makes me unsurprise
Whether she was right or wrong or whether she is a good mother or not, she has a right to make medical decisions for herself up and to the point where a judge declares her incompeten
This case is troubling on a number of levels. It points to larger cultural issues--bl
Kudos to Dr. Roth for bringing attention to this case. I look forward to hearing more of this discussion
Know your rights.
They said:
"The decision to undergo an invasive procedure such as a c-section belongs uniquely to the prospectiv
It turned out that VM, a paranoid schizophre
So, it was the mother's hysterics (caused by a long history of psychologi