| Titre : | Defensive medicine during hospital obstetrical care : a byproduct of the technological age. (2000) |
| Auteurs : | K.L. BASSETT ; N. IYER ; A. KAZANJIAN |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 51, n° 4, 2000) |
| Pagination : | 523-537 |
| Langues: | Anglais |
| Mots-clés : | Obstétrique ; Foetus ; Innovation technologique ; Innovation ; Technologie ; Evolution ; Nouveau né ; Homme ; Femme ; Canada ; Amérique ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST zB9R0x5h. Diffusion soumise à autorisation]. This paper presents an alternative perspective on defensive medicine. Defensive medicine is usually understood as arising from the effect of law on medicine through fear of litigation. Of equal significance, however, is the complementary influence of medicine on law through technological innovation, and, more importantly, the way that medicine and law develop dialectically. Each shapes the other in establishing the standards of care central to both clinical medicine and to actual or potential legal action. Excessive testing owing to fear of litigation indicates that defensive medicine is being practised in a particular setting, but it does not explain why this is so. To understand why defensive medicine occurs and why it is so troubling to clinicians requires an understanding, not only of medical and legal developments, but of a political-economic system and the beliefs and values of a society. Defensive medicine is discussed in relation to hospital obstetrical scenarios commonly associated with fear of litigation : fetal oxygen deprivation ("distress"), which is detected using an electronic fetal monitor, and prolonged labor, known as "dystocia". The material presented is taken from a medical anthropological study of obstetrical care in rural British Columbia, Canada. Litigation fears are shown to result less from rare, albeit often devastating. (...) |
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