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[Tempatan]
Unassisted Homebirth (Kes Kematian Terbaru #1772 pg71)
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Ni article best iolsss nak share dengan uolssss, reference: http://pagalavan.com/2015/06/03/ ... ality-and-autonomy/
For Future Doctors: Patient’s Confidentiality and Autonomy………
June 3, 2015 by Pagalavan Letchumanan
Well, the world is changing! I had written several times in this blog that the patients nowadays are not the same as it used to be. This is something that the current budding doctors are totally unaware when they claim that they want to “help” people by being a doctor. Only those in practise will understand what is happening out there.
Today, Malay Mail published several articles regarding ” Dr Belittle“(see below). It was about a Facebook posting which supposedly breached patient confidentiality and made various unwarranted remarks against the proponents of home/natural birth. Actually, I have been watching this ongoing debate among these group of doctors and the supporters of home birth for quite some time now. While both have their own believes , I do agree that certain unwarranted remarks or unacceptable language should not come from professionals like us. We should debate it in a civilised manner with facts rather than emotion. Saying that, I do see a lot of emotional rants in this blog by the younger generations when they don’t agree with my statements. But, do you see me doing the same?
We should understand that patients have every right to accept or deny our treatment. One of the ethics of medicine is “patient’s autonomy”. It is not mandatory for any patients to follow your treatment plan despite all the explanation given. You can scare and scold a patient but they have every right to deny any treatment offered to them. I use to get irritated by these group of patients when I was a junior doctor but after some time I began to accept the fact that our job is just to advise. You advise a patient for mastectomy for Ca Breast but she goes for traditional treatment. 6 months down the line , she comes back to you with metastasis all over the place! Do you scold her? It is her body and her life, you can’t do anything about it! Unfortunately, over the past 18 years, I have one thing which seem to be getting louder by the day. It is the refusal to seek doctor’s advise or treatment. The patient rather trust a traditional medicine practitioner despite a doctor, simply because they feel that these practitioners are prescribing and using “natural” treatment rather than chemicals. They refuse to believe that these “natural” treatment are usually adulterated with modern medicine chemicals such as steroids, NSAIDS and antibiotics. But you can advise till the cow come home and they will not listen to you. They will only listen when complications occur and they come back to you for treatment. I had seen enough Addisonian crisis, Liver toxicity and peptic ulcer disease from patients taking TCM. I had even sent some for analysis and showed them the proof.
What do I do when I see such a patient, nowadays? Basically, I don’t give a damn anymore. I tell them right to their face that since they do not want to take any treatment plan from me, please do not come to see me again for any problems. I rather treat and “help” patients who are willing to follow my treatment plan than wasting my time on patients who are never compliant. And for those who do come back to me, I will give them a piece of my mind before treating them.
Unfortunately, that is the reality out there. That’s why whenever a budding doctor tells me that he wants to help people, I tell them that not many patients nowadays really appreciate your help anymore. The real appreciation nowadays are in rural areas and interiors. Unfortunately, not many doctors would want to work in these areas. Just yesterday, I heard another Gynaecologist being sued in court. Together with him, another 2 doctors will have to be involved as they co-managed the complications that this patient had.
Coming back to the articles in Malay Mail today, I find the articles rather depressing. Firstly to the fact that many “unprofessional’ remarks were made by doctors which is not the right thing to do. NO matter what you discuss openly in any public forum/social media, patient’s details and particular should never be released. I see a lot of such pictures and details being written in Facebook which is unethical. Anything that you publish that can directly or indirectly point to any patient’s particulars, place where it took place etc can be sued by the patient. Also, please remember that a written consent must be taken from the patient for any pictures or videos taken. On the other hand, the article seem to be supporting home/natural birth proponents, blindly. While home birth is nothing new, it should be done by people who are trained medically. Even in some developed countries like N.Zealand, UK etc, midwives do deliver babies at home. However, these are done to low risk cases only. If they pick up anything unusual or feel that the patient might be high risk, the patients are referred to hospital for delivery. Unfortunately, the proponents of such method in Malaysia are mainly non-medically trained people. Majority do not take any responsibility when complications occur. Furthermore, they provide information that are not true and never disclose the complications that had occurred to their clients. No action can be taken against them as well. Remember, even some of the supporters of such methods had died during delivery.
Unfortunately, as a doctor, our job is to treat any emergency no matter who they are. They can be drug addicts, prisoners, murderers, robbers, snatch thief’s, HIV patients or even patients who refused to listen to you before. Your job is to treat them for whatever emergency they come with. If it is non-emergency, in a private sector, you can refuse to see the patient on a basis that you are emotionally not ready to treat such a patient. BUT, in government sector, you can’t, as you are an employee of the government, paid by the government to do the job.
So, if any of these patients who decided to deliver at home come to you with a complication, it is your job as a doctor to treat them. You can complain all you want, but that is your job. You decided to become a doctor to help people. So, just keep quiet and do it no matter how much anger you have in your heart. You have to accept the fact that it will never be the first or the last such case that you will see. That’s when you will ask yourself why I became a doctor when patients don’t listen to me anyway? And when the mother dies, a full report need to be sent to MOH as maternal mortality is a national index. Subsequently, you will be called for the Maternal Mortality meeting to find out why the mortality happened. I feel in such case, MOH should take action against the proponents of home births. BUT do they have the authority/law to do that?
As for the patients, it is their right. If they want to harm themselves, it is up to them. It is their life not ours. I realised this after few years of working as a doctor. BUT they should realise that they should NOT cause any problems to others as well. Don’t run to the hospital when complications occur. Take the people who advised you to do home delivery to task. Sue them or ask them to pay for the complications. Unfortunately, our society are more than ready to sue a doctor but not a traditional medicine practitioner or anyone else who has been advising them all this while. Do you see anyone suing these people? You don’t! That’s the sad life as a doctor. Not only you get sued for everything nowadays but also get called up by MMC for emotional rants, as you had breached professional ethics!
Doctor’s life is never the same anymore………………… so, It’s time for me to take another holiday on the seas….. ……
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A front page coverage .. rupa2nya writer geng puak UC .. shame on u calling all the doctor emo la apa la, when u yourself pun biased |
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damiqula replied at 4-6-2015 09:22 AM
mostly geng2 natural birth ni akan complete package ngn breasfteeding,anti vax,babywearing,cloth d ...
Tp mentekedarah MCd.. Masak ltk ajinomoto byk2..
I Ada kwn mcm ni.. Nk natural birth,breastfeed,sume2 traditional.. Tp mentekedarah fast food jah.. Latest kene czer sb ckp riak Sgt..now dah jd cerdik skit.. Ex- stewardess tuuu |
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laaaa hahahahaha no wonder lahhhhhh hahahahahahahaha.
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Tolong sampaikan dkt dr syamirullah, mesti dia excited bila tahu whos behind the front page coverage
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Geram pula i dengan writer bodoh ni |
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semalam i tengok dr. syamirulah ada post pasal 'Dr. Belittle' ni, tapi pagi ni bukak, tengok dah takde. i rasa maybe dia kena warning jugak kut.
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okayyy i dah sampaikan hahahah.
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Author |
Post time 4-6-2015 12:22 PM
From the mobile phone
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kyrana replied at 4-6-2015 11:37 AM
okayyy i dah sampaikan hahahah.
Bodoh punya reporter. Entah etika kewartawanan mana dia pakai ntah. Pandai mengata doctor. Dia menulis penuh emosi & biased tak sedar. Memalukan puak UC ni. |
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Author |
Post time 4-6-2015 12:24 PM
From the mobile phone
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Not only penyokong tegar, reporter tu sendiri pun homebirth her 2nd child... boooooooooo. Shame on u menulis ikut emosi. Tulis berita berat sebelah. Tutup pekung geng sendiri. |
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juliez replied at 4-6-2015 12:18 PM
Ehh mu tukar nick ker?
weh dh cek
forummer ni guna gambo avatar biasa jela
bkn sama ngn iols
penah gak jd gini tgk org lain guna avatar yg sama tp sebenarnya tak |
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Author |
Post time 4-6-2015 12:40 PM
From the mobile phone
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Suchi replied at 4-6-2015 12:36 PM
weh dh cek
forummer ni guna gambo avatar biasa jela
bkn sama ngn iols
Aah i dah check balik. Pelik gila. Tadi mmg keluar avatar uols. |
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So sad this issue naik lagi. At the same time bgs jugak dpt publicity macm ni, people can google nama doula yatt & amy karmila. I heard one of the doctor yg komen kat fb pasal 4rd degree tear tu kena ugut.... Maybe tonight dia nak up status about this matter. However kena la beringat para pengamal UC kalau dah ludah doctors jgn la hadap bila ada complications masa beranak tu. shame on them |
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juliez replied at 1-1-2014 11:16 PM
Terms
Unassisted Childbirth (UC)
Setan suka la jilat uri tu... Letak rosemary sekilo pun setan kenyang makan uri marinated. Lotus birth mmg dah jauh menyimpanh dari ajaran Islam.... Hipster yg amalkan benda ni |
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tightcherry replied at 4-6-2015 09:41 AM
Tp mentekedarah MCd.. Masak ltk ajinomoto byk2..
I Ada kwn mcm ni.. Nk natural birth,breastfeed ...
Once i stumbled upon fb posting by antivax, dia jual makanan sunnah kot. Sekali order dominos haha |
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juliez replied at 4-6-2015 09:40 AM
A front page coverage .. rupa2nya writer geng puak UC .. shame on u calling all the doctor emo la ...
Yup ida is one of GBG admin or members gitulah.... Alaaa ape nak hairan, malaymail kan paper free. Article pun yg murahan je dapat cover. Paper lain tak kuasa |
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ak pon speech less nh . .  |
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Post time 4-6-2015 09:30 AM
