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Peggy O'Mara on Freedom of Conscience and Informed Consent

At the 2009 Coalition for Improving Maternity Services Mother-Friendly Forum that just ended today, one of the presenters made reference to the article “The Assault on Freedom of Conscience” in the January/February 2009 issue of Mothering Magazine. The piece was written by Peggy O'Mara, the magazine’s editor and publisher.

The following excerpt was written in regards to HIV-positive pregnant women who declined AZT treatment during pregnancy and one woman in particular who took the AZT but was court-ordered by her pediatrician after her birth to cease breastfeeding and administer AZT to her baby. This applies to  all parents:

These parents exercise their freedom of conscience—a right supported by US courts for more than 100 years. Freedom of conscience is protected under the doctrine of informed consent, which specifically protects the right to decline. For informed consent to be valid, a decision must not be coerced.

O’Mara concluded the article by urging parents and families who have made a responsible and well-informed decision to dismiss propaganda.

A dangerously vicious intolerance for parents' freedom of conscience is growing and is breeding an atmosphere of distrust among families. It's especially important now for parents to clearly differentiate between the personal and the political. If you exercise your freedom of conscience and make a decision that is held by only a small minority, be reassured by the knowledge that the Constitution of the United States was written specifically to protect minority opinions. If you have made a responsible and well-informed decision, you can dismiss the propaganda when an issue is demonized in the press, because its coverage may be influenced by political, that is, financial, motives. Parents are the only ones who will live with the consequences of their actions, so they must be the ones who make the final decisions. Anything else is tyranny.


The argument to this, of course, is that children, too, must live with the consequences of their parents’ decisions. What do you think?


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Reader Comments (6)

The child, given his or her relative inability to make those kind of decisions on their own, is going to have to live with the consequences of whatever decision is made - no matter who makes it. It's not like the so called "experts" or people in power are infallible and will always make the right decision, for the right reason. The question is - who do you want to be making the decision? A person who (generally speaking, there are always exceptions) does so from a place of love and who has made a commitment to that particular child for their life or an outsider who makes decisions from a different perspective (public health, etc)? That's not to say that there is some vast conspiracy theory and the "experts" or outside folks wish the child harm, but let's face it they're perspective is not the same.

March 8, 2009 | Unregistered Commenterpampered_mom

This reminds me of the UNICEF crap in Botswana where they forced mothers to formula feed to "protect" the baby from HIV, when in fact, it killed the babies in 20 times the numbers because HIV has a VERY small chance of passing through breastmilk, and breastmilk protects babies from all kinds of other infections diseases that run rampant there. UNICEF changed its position, ya know... AFTER it killed all those babies.

But, with that said, I think that parents have the responsibility to make INFORMED decisions about their children's health and welfare. Some of the parenting choices I see make me cringe - like the woman who watered down her baby's formula because she "thought it was the right thing to do." Idiot.

March 8, 2009 | Unregistered CommenterTheFeministBreeder

Being pregnant, I recently went in for routine blood work and was surprised when the doc. rattled off HIV as one of the tests. I immediately asked her if she needed written consent to perform an HIV test. She said "No." that it was routine and included with the other tests. I asked what the ramifications were if the test were positive. She replied that HIV+ women received special care during pregnancy. I asked her to outline what care and she said she didn't know because she was only a GP. Eventually she said that I could decline the test she was "offering" if I chose, but that fact came at the end of the conversation, not at the beginning where it belonged.

My impression? Women are being coerced into HIV testing with out consent, and this is not justifiable.

In my state you must legally (1) determine if the woman has any risk factors for HIV infection other than just intercourse ie. multiple new partners, IV drug use, etc.(2) Relay information about the risks of testing + during pregnancy, including information on antibody count, drug therapy, poss. c/sec, statistics on fetal infection, and the possibility of false positives (3) provide information about pre and post test counseling and (4) inform the woman that if the test is positive she will be contacted by the doc. personally and retested to rule out a false positive (5) inform about the legal responsibilities of the doc. to inform health services (6) inform that the woman will then have legal responsibilities that could include not only naming past partners, but informing new ones (7) information about baby care and breast feeding (8) The information provided should be written and the woman should be able to take it away with her and then make her decision (9) the woman should be provided with sources to find more information if she chooses (10) Make sure the woman knows that the test is not mandatory. Again, this should be #1.

How many women are sitting at home right now worried about the results of their "routine" HIV test? Women who are in monogamous relationships on their 2nd or 3rd child. Women on their second marriage. New brides. Single moms. Women who have been tested before and were negative, but got roped into it again. The stress, the knowledge that if it's + that it's likely that their partner was cheating, the fear.

This too is violence against women.

No person in any state of health should be coerced into any procedure. Consent is subject to and outlined by legislation. Doctors and hc providers are apparently above the law and are colluding to keep it that way. Doctors are now beginning to require new patients to either sign documents requiring them to forgo posting comments about their care on-line on sites like Web MD, or they will not be taken on as a patient. So, either give up freedom of speech or be untreated. And who is regulating the doctors? Not the consumers as in every other service sector. They are supposed to be self regulating but instead are self interested, self serving, and committing crimes. Hippocratic what? Huh?

March 9, 2009 | Unregistered CommenterAnon

And, children have to live with the consequences of their parents taking the advice of hc practitioners, which is a decision, and not always a good one. Practitioners would like to blame on the parents' for not being informed enough to decline procedures, when the law clearly outlines the Physician's Duty to Inform the patient of the general and remote material risks including what would happen if no actions were taken.

So where is the line here, when physicians are practicing illegally by not obtaining consent, and parents are relying on the doctor-patient relationship? Is it really the parents' fault for trusting that their doctor is going to be honest with them? Legally no, but try telling that to someone who is beating them selves up about how stupid they were for listening to their doctor and not looking further into things. Try telling that to the families that come home from the hospital grieving for the loss of autonomy, health, baby, uterus, mother, or other, and not in that order.

So should doctors have to abide by laws governing informed consent, or do patients have to take for granted that they're doctor is a risk factor unto him/her self, and research accordingly? And if patients cannot trust their doctors, and have to research to come to and educated pathway, who's at fault when there are adverse events? Will our future doctors be able to practice without fear of liability because, gee, the patient is responsible for finding out all of the necessary information themselves and coming to a decision independently of the doctor? Or, are we all going to watch through cracks in our curtains as the paddy wagon comes for the 39 week pregnant women to take them by force to the hospital?

March 9, 2009 | Unregistered CommenterAnon

The subject of routine HIV testing came up at a conference last week. A conference attendee expressed anger at the idea of testing all pregnant women even with an opt-out policy. The presenter's point was that many of the women (I think she even said "good women") had no idea how they had contracted HIV; therefore, it was information that they wouldn't have had otherwise (probably because the "good" women wouldn't be profiled and tested under the assumption that they are promiscuous or drug-addicted).

March 10, 2009 | Unregistered CommenterUnnecesarean

All of your replies had the same theme. In cases of negative outcomes, the child experienced the consequences of either the parent's decision to forego treatment (vax, surgery, whatever) or the parent's decision to submit to the program laid down by docs, the government, etc.

Medical, public health and child welfare authorities and officials are quick to pin down parents and hold them responsible for anything that happens to their children as a result of denying them the recommended treatment. However, they are quick to shuck responsibility for any negative outcomes associated when a child is injured by his or her parents' compliance.

"Tyranny" is a pretty good word in this case.

March 10, 2009 | Unregistered CommenterUnnecesarean
This blog is all done!
Thanks for wanting to comment. This is an archive of a blog that once was. Take care! Jill