Leila Asadi; Marjan Beigi; Mahbube Valiani
Abstract
Background: Maternal and neonatal health indicators have the important role in evaluating community development.
Objectives: In this study, we examined the effects of maternal and fetal complications leading to midwifery errors in referred cases to the Iranian Legal Medicine Organization and Medical ...
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Background: Maternal and neonatal health indicators have the important role in evaluating community development.
Objectives: In this study, we examined the effects of maternal and fetal complications leading to midwifery errors in referred cases to the Iranian Legal Medicine Organization and Medical Council of Forensic Medicine from 2006 - 2011 in Isfahan, Iran.
Methods: In this cross - sectional study, we evaluated all midwifery cases that were referred to the Isfahan Legal Medicine organization and Medical Council of Forensic Medicine from 2006 - 2011 that had at least one warrant issued by the outcome of the Disciplinary Board. The data were collected by a checklist and analyzed by SPSS - 18. Research data were qualitative and quantitative (discrete and continuous variables).
Results: A total of 206 cases were reviewed. In 66 cases, 32% of them the malpractice verdict in midwifery services was approved. According to our findings, the most maternal and fetal errors led to the complaint include: fetal or neonatal death (29.4%), maternal mortality (18.1%), and neurological disorders (15.3%). In addition, the highest rates of maternal medical malpractice were maternal mortality (56.8%) and in infant complications, infant mortality with 28.8% frequency (P = 0.03).
Conclusions: It seems the maternal health program effort is impaired in our country. The maternal mortality is unacceptable, due to the fact that many of them are preventable. Taking strategies to prevent replication errors within the care of pregnant women is recommended.
Manavi Handa; Mary Donovan Sharpe
Abstract
Context: This article discusses the paradigm shift in health care and bioethics from the concept of informed consent to informed choice.
Evidence Acquisition: Informed consent is linked to the concept of respect for autonomy-one of the four pillars of bioethics. This concept requires health care givers ...
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Context: This article discusses the paradigm shift in health care and bioethics from the concept of informed consent to informed choice.
Evidence Acquisition: Informed consent is linked to the concept of respect for autonomy-one of the four pillars of bioethics. This concept requires health care givers to share information with patients so they can make appropriate health care decisions. However, the concept of informed consent has been critiqued as being paternalistic and not attentive to the complexities of modern health care decisions.
Results: As a result of a paradigm shift in health care and ethics, favoring autonomy over other principles-informed consent evolved to the more patient-centered concept of informed choice. Even so, feminist bioethicists critique the mainstream model of informed choice as being inattentive to inherent power dynamics within health care and society which may influence decision making. Drawing on the model of midwifery in Canada, this paper outlines an approach to health care that incorporates feminist definitions of informed choice.
Conclusions: This paper reviews the necessary criteria for informed choice to be attentive to the individual needs of women. Using the model of midwifery in Canada as an example, this paper demonstrates how feminist approaches to informed choice should be preferred in modern health care settings.
