Can a woman refuse an emergency csection ?

klone, MSN, RN · Apr 8, 2014

It is illegal to perform surgery on someone against their consent.

We've watched fetuses die because the parents refused a C/S.

If she were mentally ill, however, it's possible to get a court injunction, but I don't see how there would be time for that in most situations.

SanDiegoCaliRN · Apr 9, 2014

Not at my hospital and I don't think legally a C/S can be performed against a woman's will anywhere. Written consent is required to operate because until the baby is born, it doesn't have "rights."

We had a North African woman refuse a C/S for recurrent prolonged late decels and there was nothing we could so but watch her baby die (C/S are culturally forbidden where she was from). It was very tragic and emotionally devastating for everyone involved but there's nothing you can do if you can't obtain the woman's consent.

SanDiegoCaliRN · Apr 9, 2014

I had a mentally retard patient once and her mother, who was her legal guardian and conservator, gave written permission on her behalf to perform a C/S. That baby had a lot of problems but it survived

pixiestudent2 · Apr 9, 2014

Oh, this is terribly sad

NicuGal, MSN, RN · Apr 9, 2014

We have obtained court order for a few very mentally ill patients and a few very developmentally delayed patients who were first evaluated by psych and declared incompetent. It is actually very sad.

I have also seen a few neonatal deaths and severely compromised kids from Mothers who just flat out to have a section. There is no reasoning with them.

Katie71275 · Apr 9, 2014

You can refuse anything you want as a patient. The outcome may not turn out well, but that is your prerogative as the patient. If it's a TRUE emergency C-section, then there is not time to receive a court order. Things like that take time.

elkpark · Apr 9, 2014

As a few posters have suggested, if someone is found to lack the mental capacity to make informed decisions about healthcare procedures, providers can then look to family members (or, less frequently, the courts) to make the decision for the person. Lots of people don't get to refuse medications or procedures. However, people who are determined to have capacity to make informed healthcare decisions are able, legally, to decline life-saving or life-sustaining treatments and procedures.

Apparently, there are some states that now have laws that favor the fetus over the mother's health or wishes (witness the recent national press coverage of a few cases in which individuals' and family members' wishes re: withdrawing life support were overruled by the state in the case of a pregnant woman). In those states, I don't know how a woman's attempt to decline an emergency C section would turn out.

Also note that being "mentally ill" does not automatically mean a person lacks capacity to make her/his own healthcare decisions.

KelRN215, BSN, RN · Apr 10, 2014

Yes, she can. It is illegal to perform surgery on someone without their consent. A competent adult is free to make whatever decision she chooses, whether it's considered to be a good decision or not. Performing surgery on someone without her consent is assault.

elkpark · Apr 11, 2014

Yes, she can. It is illegal to perform surgery on someone without their consent. A competent adult is free to make whatever decision she chooses, whether it's considered to be a good decision or not. Performing surgery on someone without her consent is assault.

Again, while that's generally true, I'm not sure how the scenario would play out in the growing number of states passing laws that value the health of a fetus over the health/life of a woman ...

monkeybug · Apr 11, 2014

I have seen a bedside committal. It actually happened pretty quickly. In small towns, the doctors and judges may be friends, and it might not take more than a phone call. At least that's the way it happened in what I witnessed. And in the end, the patient was grateful. She was hypoxic and therefore not thinking at all clearly. The idea still makes me squirm though, as I very much believe in autonomy.