Electronic fetal monitoring, cerebral palsy, and medical ethics: Nonsense of a high order1

2017 ◽  
Vol 17 (1-2) ◽  
pp. 43-64 ◽  
Author(s):  
Thomas P. Sartwelle ◽  
James C. Johnston ◽  
Berna Arda
Keyword(s):  
Cerebral Palsy ◽  
Paradigm Shift ◽  
Fetal Monitoring ◽  
The Past ◽  
Overwhelming Evidence ◽  
Electronic Fetal Monitoring ◽  
The Face ◽  
Medical Paradigm ◽  
Junk Science ◽  
Scientific Technology

Electronic fetal monitoring (EFM) was predicted by its inventors to be the long-sought cerebral palsy (CP) nemesis. Rather than prevent CP or any other birth problems, 40 years of EFM use has done substantial harm to mothers and babies and created a worldwide CP-EFM litigation industry that enriches only trial lawyers. Physicians, frightened by the ever-expanding and costly CP-EFM litigation crisis, and focused on avoiding lawsuits at all costs, embraced ethical relativism—charitably called defensive medicine—and continued EFM use even in the face of overwhelming evidence that EFM is merely junk science. In doing so, physicians completely abandoned the bedrock bioethics principles of autonomy, beneficence, and nonmaleficence. This daily ethical drama has played itself out for the past almost half century with little protest from obstetricians and no protest from ethicists. This article reviews EFM harms, the CP-EFM litigation crisis, and the resulting abandonment of bioethics principles and explores why the CP-EFM paradigm has failed utterly to follow the Kuhnian model of the scientific, technology, medical paradigm shift.

Cerebral palsy, cesarean sections, and electronic fetal monitoring: All the light we cannot see

2019 ◽  
Vol 14 (3) ◽  
pp. 107-114 ◽  
Author(s):  
Thomas P Sartwelle ◽  
James C Johnston ◽  
Berna Arda ◽  
Mehila Zebenigus
Keyword(s):  
Cerebral Palsy ◽  
Fetal Monitoring ◽  
Cesarean Sections ◽  
Electronic Fetal Monitoring

“Graphics, Social Movements, and the Race to Eradicate Abortion: Why America Will Take Gold”

2016 ◽  
Author(s):  
Zuza Kurzawa
Keyword(s):  
Social Movements ◽  
Paradigm Shift ◽  
Freedom Of Expression ◽  
Past Century ◽  
Societal Change ◽  
The Past ◽  
The Face ◽  
Common Goals ◽  
Graphic Image ◽  
Pro Life

Skeletal figures of Holocaust victims, wounds and scars of the enslaved, blackened lungs of the smoker; powerful images convey powerful narratives. Over the past century, media has become increasingly pervasive. For social movements, this tool played a key role in achieving mass societal change. Looking to mimic a lasting paradigm shift, pro-life groups have realized that images are the catalyst for change. Ignoring the normative element of abortion, it is important to acknowledge two common goals shared by the pro-life and pro-choice communities. First, both desire to help women. Second, both want to reduce the number of abortions. The obvious disconnect, is the means under which both goals are met. However, over the past decade, the efforts of various ‘Centres for Bio-Ethical Reform’ have shown that one of the most effective methods in achieving both goals has been through graphic image campaigns. It will be argued that in order to help couples make informed decisions, and reduce the number of abortions, images of human development and abortion must be readily available to couples in crisis pregnancy. Using the findings and testimonies from the Centre for Bio-Ethical Reform Florida 2011 mission, it can be demonstrated that convictions about abortion change in face of graphic imagery. Because it does not overtly challenge current legislation, but instead decreases the number of abortions, it ought to be honoured by both parties. Under the protection of the first amendment, pro-life groups in America can freely share these images to encourage discussion. In Canada, ‘freedom of speech’ and ‘freedom of expression’ are often compromised in the face of adversity; conclusively the pro-life message is often silenced. Thus, by virtue of being able to share the reality of the procedure, Americans are leading in the race to eventually eradicate the perceived necessity of abortion.

ELECTRONIC FETAL MONITORING: WISHING AWAY TRUTH

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. A86-A86
Author(s):  
Student
Keyword(s):  
Cerebral Palsy ◽  
Neurological Outcome ◽  
Fetal Monitoring ◽  
Complex Situation ◽  
Relevant Evidence ◽  
Electronic Fetal Monitoring

The act of throwing into stark relief the unreliability of intrapartum EFM as a predictor of long-term neurological outcome threatens two other much more important beliefs: that the use of EFM can prevent cerebral palsy and that intrapartum asphyxia is the cause of cerebral palsy. It is no wonder that there is resistance to collecting relevant evidence and giving it credence. "I had not properly realised, until this time, the power of wish to distort and deny—and its prevalence in this complex situation, where enthusiasm of doctors and the distress of patients, might lie in an unconscious collusion, equally concerned to wish away an unpalatable truth."

Uncertain Value of Electronic Fetal Monitoring in Predicting Cerebral Palsy

1996 ◽  
Vol 334 (10) ◽  
pp. 613-619 ◽  
Author(s):  
Karin B. Nelson ◽  
James M. Dambrosia ◽  
Tricia Y. Ting ◽  
Judith K. Grether
Keyword(s):  
Cerebral Palsy ◽  
Fetal Monitoring ◽  
Electronic Fetal Monitoring

scholarly journals Cerebral Palsy is 25 or More of Hypoxia Index and No Cerebral Palsy is 24 or Less of Index in Fetal Monitoring

2020 ◽  
pp. 1-4
Author(s):  
Kazuo Maeda ◽  
Keyword(s):  
Cerebral Palsy ◽  
Fetal Heart ◽  
Fetal Brain ◽  
Fetal Monitoring ◽  
Fetal Outcome ◽  
Fetal Hypoxia ◽  
The Past ◽  
Late Deceleration ◽  
Pattern Diagnosis ◽  
Chi2 Test

Fetal outcome was ominous if fetal heart rate (FHR) was late deceleration (LD) in the past, while 3 connected typical LDs were normal, and repeated LDs for 50 min were heavy fetal brain damage. Also, LD is defined as LD when it is repeated for 15 minutes. As the fetus is damaged by repeated hypoxic decelerations followed by cerebral palsy, but not by its late appearing in LD, novel fetal hypoxia index (HI) is the sum of all deceleration durations (min) divided by the lowest FHR (bpm) and multiplied by 100 in fetal monitoring. The hypoxia index was 25 or more in all of 6 cerebral palsy cases, while it was 24 or less in all 16 cases of no cerebral palsy. As error probability is almost zero in the chi2 test of hypoxia index, no cerebral palsy is decided when the hypoxia index is 24 or less, while it is cerebral palsy, if hypoxia index is 25 or more. The hypoxia index is adopted to all FHR decelerations and bradycardia, as hypoxia index does not evaluate the late appearing of deceleration, instead of past subjective deceleration pattern diagnosis in fetal monitoring.

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