My phone rang late at night while I was on a trip abroad. A female gynecologist called me up and said that she’s on her way to a hospital to help a pregnant woman who was in labor. The woman was admitted into hospital an hour before and the gynecologist was ringing to consult me on an issue. The woman’s husband had signed a paper prohibiting the hospital from performing a Caesarian delivery under any circumstance even if the baby’s life was in danger.
I asked the gynecologist, who has accreditation from the American Board of Medical Specialties and has worked in the United States a number of years, how American doctors would react in a similar situation. She told me that such situations were rare in the US because there the mother is always the decision maker when it comes to childbirth.
The life of a pregnant woman was at stake because people are ill informed of the reasons why doctors resort to the Caesarian section to quickly deliver a baby. For example, in cases where the umbilical cord surrounds a baby’s neck — something that can only be found out just before the delivery — a Caesarian section is the immediate option to save the baby and prevent it from having a permanent disability.
I asked the gynecologist what happens in cases when parents refuse to approve the required surgery to save the baby. She said hospital workers usually seek a judge’s help and get at least his verbal approval if the emergency occurs in the middle of the night. Protecting life is the state’s responsibility when the parents fail to provide their unborn child with the necessary protection.
I prayed to God to guide me. After some reflection, I thought of calling Dr. Mohammed Al-Bar, a member of the hospital’s ethics committee and a consultant of the Muslim World League. But I became reluctant to wake him up at that late hour. Finally I decided to contact the woman’s husband. I phoned him up and, after introducing myself, wished his wife an easy and safe delivery. Then I asked him about his decision to prohibit a Caesarian section and whether he was aware of the consequences. I was shocked to hear him scream, “Let the baby die.”
My tone changed. I told him that if he’s willing to kill his child or let it be born with a permanent disability then the gynecologist, the hospital and I myself do not want to be partners in that crime. It was then that the man started listening. Time was running out and I tried my best to convince him. He finally agreed to give the doctors the freedom to make a decision in order to save both the mother and child.
Minutes later, I learned that the man, having taken the advice of friends and relatives, had signed documents giving doctors permission to do whatever they needed to do. Later it transpired that some ignorant people had told the man that a Caesarian section costs more than a natural birth and hospitals would exploit patients by unnecessarily rushing to surgical delivery.
That moment I realized that the biggest challenge facing the Kingdom’s health sector isn’t achieving the highest quality of service, hiring the best doctors, buying the latest equipment, or adopting the finest policies. The biggest challenge is for the doctors and hospitals to regain the confidence and trust of the public.
The process of recovering trust requires huge efforts and a lot of time. Complications are possible even in the best of medical centers in the world. These cannot be called medical mistakes, but rather be referred to as unexpected complications.
In less than 15 minutes I was able to gain the trust of a person who in fact had been misled by ignorant people. At the end of our conversation he asked me what he should do. I told him to go to the hospital and cancel the paper he had signed — and he did exactly that.
In an hour, the man called me back and cheerily told me of his newborn child. He prayed for my health and happiness as well as that of the gynecologist and thanked us for the patience and support we gave him.
We as doctors have a huge responsibility to spread awareness among people, especially regarding women’s health. At the end of the day, mothers should have the final say in situations such as this. We also have to work hard in restoring patients’ trust in our doctors and hospitals. Many studies have emphasized “the faith factor” as an important element in helping a patient recover.
Doctors also need to clarify rules and regulations related to medical issues and facilitate means of conveying these facts to patients and other doctors.
In emergency situations, cooperation between doctors and the authorities must be ensured day and night.
