A 36 week pregnant woman signs a form saying she does not want, under any circumstances an epidural?

Question

Later while in the middle of a prolonged and painful labour she begs for and is given and epidural.

Mother and child survive in excellent health.

She then sues the anaesthetist for over-riding her written instructions NOT to be given an epidural, although she freely admits she did say in effect 'To hell with what I have signed, stop the pain'

Her lawyer argued that in the intense pain of labour a womans wishes should not be allowed to over- ride her written intructions.

The judge agrees and damages are awarded against the anaesthetist,

Can this be right and what does it mean for women in that postion in the future?

This is a real case causing real concern.

It took place in Adelaide Southern Australia.

And, the point is, no matter what we think, she won.

Answer 1

An excellent question and an interesting set of answers.

Essentially, what she made as a signed 'non consent' has to be adhered to.

In the throws of labour, people say all sorts of things that they later either do not remember or regret. In addition, she could have been taking gas which may have affected her judgement. At the time she requested (and insisted upon) the epidural she was not offered the opportunity to recind and overrule her previous request *in writing*. Had the hospital done that, they may have been in a better position of defence. Also, the original request stated 'under any circumstances'.

It is very surprising that the hospital 'gave in' to an epidural as most often these days, they either say 'it's too early' or 'it's too late'.

The hospital could however have argued that they were forced to give her an epidural for the following reason. If the mother is not fully dilated yet is pushing the baby out, this can cause a severe tear in the cervix. Hospitals do sometimes try to slow down the urge to push by administering a partial block (epidural) to get the mother to relax and allow some more time for the cervix to dilate further.

However, if I'd been at the hospital and forced to make the decision, I would have opted for a C section at this stage as the labour was long, drawn out, the mother was becoming overly distressed and the epidural was not allowed.

So, all things considered, I believe that the hosital was wrong to give her the epidural, but the mother was also wrong to pursue them through the courts. If I'd been a judge I would have found in her favour, but awarded her minimal damages as she could have asked fo ra C section herself instead of going against her written request to not have an epidural, and she could have 'engineered' the whole thing.

Answer 2

Wow, is this a real case? I missed that one...

OK, firstly there is no legally binding form you can sign refusing technology in advance of birth. That would be ridiculous - what if you suddenly find you need a forceps or caesarean delivery and the whole situation is very different to the natural birth you had anticipated? All that you could produce would be a birth plan - a *plan*, not a contract, not a directive.

It is certainly true that many, many women who were adamant that they didn't want an epidural before labour beg for one during labour, especially towards the end of the first stage. At that point she is therefore not only giving consent, but actively *requesting* intervention. It is ridiculous to say that decisions made in the pain of labour should not override prior choices, as before labour you are making decisions based on an incomplete picture of what you will have to face.

If this lady was that against epidurals she should have booked a home birth so that there was no possibility of her giving in and requesting one!

What this would lead to would be even greater fear of litigation on the part of anaesthetists, obstetricians and midwives, and therefore a greater reluctance to provide women with an epidural (and maybe other pain relief, such as pethidine or meptid) where a woman has said or written in advance that she doesn't want any pain relief. What this would mean for women is that they may be denied the right to change their minds if the reality turns out to be harder to cope with than their imaginings.

Answer 3

I think this is ridiculous, the whole culture of sueing everyone is ridiculous. You can't breathe without fear of someone sueing you. It pushes up insurance prices and stops people doing things just because some idiots want to get all they can for nothing.

Even in labour you can make a proper decision, I know I have been there twice.

What would have happened if the woman hadn't received the epidural? Would she have then found a way to sue because she was put through that pain when she specifically asked for an epidural? I'm sure her lawyer woudl have found a way to fight that.

And how can you take a thing like childbirth and turn it into a way to make money. You're giving life. Your main focus should be your child not how to make a quick buck from it. She probably had it planned all along. It's sickening.

Answer 4

I am the person who posted the original question.

I am concerned that some answers doubt the the truth of the proposition.

My daughter is an Anaesthetist although not THAT Anaesthetist in Australia and the case is a matter of considerable debate amongst her peers.

She also points out that the Anaesthetists role and duty is to prevent pain, which puts them 'between a rock and a hard place'

Thank you for your answers, it is gratifying that such a serious case is treated seriously, not all question get (or deserve) the same respect.

Answer 5

The Judge was wrong. The woman should be prosecuted for fraud, malicious litigation and sheer bloody stupidity.

Please note: I'm not against women having epidurals, but to sue in these circumstances, after the event, when no harm was done... that's just deceitful.

Answer 6

So you claim this is a real case? Then provide a link so I can read it for myself. Whenever I read a something like this, I find that there is usually a lot more to the story.

You've all about the McDonald's coffee case? Yes, people should be careful with their coffee. However, coffee also should not cause third degree burns either. There is always more to the story.

Answer 7

The women in question should be grateful that her and her baby are in good health. I'm surprised and shocked that she was able to make a signed document about something neither her or the medical professionals were able to predict an outcome on.
I wonder why the document wasn't destroyed by herself if her wishes had changed.
What a sham!

Answer 8

This is surely a case where the court should have marked its displeasure by awarding nominal damages of 10 cents or so and no costs. I'm with Mr Micawber on this one. The law's an ***!

Answer 9

I don't know fully, but in my AS business, my teacher said that a pregnant woman should be able to have her job available to her for a year, once she'd gone on maternity leave or something. Check the unions, I would.

Answer 10

She should have been made to sign the form, if she can scream and dictate that she wanted one surely in her best interest her or partner could have signed another consent form to say shes changed her mind!! Typical woman!!! I think that this case shows how people will try to get something for nothing and it was all her fault... It makes you wonder !!!