Give us back our voices
Two weeks ago, I read a very powerful post from Mind the Baby about a woman who lost her case against the HSE: The High Court says we can’t say No. This case resonated with me so much. I could try to summarise the details of the case and the judgement but I wouldn’t do it justice compared to the post from Mind the Baby, so if you haven’t read it yet, pop over to her site and read that first.
What strikes me most about the case is how voiceless the woman in question is. First in the hospital she is denied the chance to make an informed refusal of the procedure that the midwife carried out. Then in the court, not only did she lose the case because the midwife was deemed to be “…the person entitled, authorised and qualified to make the decision”, but she had costs awarded against her, a punitive step to silence her further.
So what happens now the next time a woman has her right to informed consent trodden on? What recourse does she have? Well none, really, because we have a judgement saying that the midwife is the one with the right to make decisions, coupled with the fear that if you take a case, you’ll be forced to pay the costs for both sides. So unless you’ve got limitless resources, consider yourself silenced.
This case has really hit me. I find myself thinking about it regularly since I learned of it. What we’re talking about here is our right to say no. We’ve lost it. Or maybe we never had it.
What are you complaining about? Haven’t you a healthy baby, what more do you want?
Isn’t that what most people think? When the case above was published on Broadsheet.ie, the negative comments started immediately, along the lines of “who does she think she is?”, and the usual “she should be grateful for a healthy child.” They continued until the father of said “healthy child” grew so exasperated with them that he commented at length explaining that they do not, in fact, have a healthy child. And suddenly the tone of the comments changed. We didn’t realise. Oh in that case…
Have we learned nothing?
Ours is the culture that led to the victims of symphysiotomy having unwarranted procedures carried out without their informed consent. And here we are years later and it seems that as far as the courts are concerned the medical practitioners are still entitled to decide for us what is best, with no obligation for them to adhere to international best practice.
I have some small personal experience of this from my time in hospital giving birth to my daughter. I had found the admissions trace very difficult when having my son, so I wanted to avoid it second time around. When the admitting midwife asked me to lie back for the trace I refused, at which point she told me “if I can’t examine you, I can’t admit you.” So I lay back for the trace. Was that informed consent? I don’t believe so. I felt coerced, not consenting.
Afterwards, I complained in writing to the hospital, including in my complaint my understanding that admissions traces for low risk women were not recommended in the National Maternity Guidelines. When the response came, months later, it told me that I could have refused the procedure at any time. But I did and my refusal wasn’t accepted. And it went on to say that although the National Maternity Guidelines don’t recommend admissions traces for low risk women, the hospital consultants policy is to do them.
I guess that’s that then. The hospital consultants have spoken and their voice is more powerful than mine.
How can we change this broken system? Why are we so afraid of letting people make informed decisions about their own healthcare? And why are hospitals not implementing international best practice as their default policies? It’s time we take back our voices and raise them. It’s time to shout.