The American College of Obstetricians and Gynecologists’ (ACOG) Committee on Ethics released a “Committee Opinion” [in June 2016] that outlines what doctors should do when a woman refuses the treatment recommended to her by an obstetrician.
A desire to protect the health and safety of the unborn baby may be at odds with the ethical obligation to safeguard a woman’s autonomy and right to choose what happens to her own body. In these cases, the Committee says, doctors are obliged to respect the patients decisions without attempt at coercion.
The authors brought up issues of bodily autonomy, gender equality, the power dynamic between doctor and patient, and basic human rights.
Even though the doctor may truly believe what s/he is recommending is best for baby and mother, using coercion, guilt, threat, or force is a discriminatory act and acts as a barrier to care. Essentially, it’s a violation of the Hippocratic Oath, and the authors of the Opinion hope to eradicate the practice from their profession.
The central issue is in the pregnant woman’s authority to make decisions about her care. Being pregnant, they say, does not negate the right a patient has to refuse treatment, even life-or-death treatment. No matter what, the woman should be assured that her decisions will be respected.
Doctors are warned that, because medical knowledge is limited and prognostic certainty even more so, the use of coercion is unacceptable both medically and ethically. A doctor cannot know for certain that the recommendation is absolutely the best course of action–and even if it were so, s/he shouldn’t force it upon you.