Medical neglectLet us be clear: UC (unassisted childbirth) and UP (no prenatal care) are forms of medical neglect. The mother may have what she considers to be good reasons for medical neglect, but it is medical neglect all the same. When you show up at the hospital requesting emergency treatment, the OBLIGATION of the hospital staff is to provide medical treatment. In an emergency, the hospital staff is under no obligation to respect a parent's desire for medical neglect or to carefully explore why the parent thinks her reasons for medical neglect are better than other people's reasons for medical neglect.
There are many reasons why parents commit medical neglect, and the desire for a bizarre birth "experience" is one of the least common and least defensible reasons for medical neglect. According to the American Academy of Pediatrics position paper Recognizing and Responding to Medical Neglect, written by Carol Jenny of the AAP Committee on Child Abuse and Neglect:
Several factors are considered necessary for the diagnosis of medical neglect:UC and UP certainly fit that definition of medical neglect.
1. a child is harmed or is at risk of harm because of lack of health care;
2. the recommended health care offers significant net benefit to the child;
3. the anticipated benefit of the treatment is significantly greater than its morbidity, so that reasonable caregivers would choose treatment over nontreatment;
4. it can be demonstrated that access to health care is available and not used; and
5. the caregiver understands the medical advice given.
Reasons for medical neglect include: poverty, lack of access to care, family chaos, lack of awareness, lack of trust in health care professionals, and caregiver’s belief systems described as:
Some caregivers have belief systems that are inconsistent with Western medicine. A parent of a child who has a serious illness may decide to rely on untested remedies or alternative medicines. Some caregivers will seek healing through religion rather than medical care...The paper outlines the provider's ethical and legal obligations when confronted by medical neglect due to parental beliefs:
Medical neglect evaluations should focus on the child’s needs rather than the caregiver’s motivations or justifications. Religious objections, therefore, should not be granted fundamentally different status from other types of objections.There is no special status granted to religiously motivated medical neglect, and therefore, there is no special status granted to medical neglect motivated by subcultural belief systems.
Although competent adults have the right to refuse life-saving medical care for themselves, the US Supreme Court has stated that parents do not have the right to deny their children necessary medical care. The court made this clear in 1944 in Prince v Massachusetts. "The right to practice religion freely does not include the liberty to expose the community or child to communicable disease, or the latter to ill health or death. . . . Parents may be free to become martyrs themselves. But it does not follow they are free, in identical circumstances, to make martyrs of their children. . . ." The American Academy of Pediatrics has taken a firm stance on the rights of seriously ill children to receive lifesaving medical care even if their parents subscribe to religious beliefs that are antithetical to medical care.
UC, in addition to being a form of medical neglect, also involves the willful refusal of medical treatment for the mother. That is a decision that she is free to make for herself. However, if she expects health care providers to comply with her wishes to refuse medical treatment, she MUST make that clear to the health care providers PRIOR to any medical emergency. For example, patients who are nearing the end of life and do not want to be resuscitated in the event of a respiratory or cardiac arrest MUST put that declaration is a legally prescribed written form. A patient CANNOT call for an ambulance for difficulty breathing and then refuse treatment in the emergency room claiming that she would rather die. The medical team cannot ethically or legally stop treatment on the basis of a request in the midst of an emergency.
Similarly, if the mother calls for an ambulance for a complication of childbirth, she should not expect that anyone is going to honor refusal of treatment or various aspects of treatment. The medical team cannot ethically or legally stop emergency treatment on the basis of a stated request in the midst of that emergency.
The self righteousness of the UC community is mind boggling. They are committing medical neglect and their reasons for doing so are not privileged above anyone else's reasons for committing medical neglect. They are entitled to refuse medical care for themselves, but they are not entitled to call for emergency medical assistance and then refuse that medical assistance without prior, legally sound documentation of their beliefs and legally sound documentation that they understand the consequences of refusal. Far from being the party ethically legally violated in emergency UC transfer, they are the party committing ethical and legal violations.