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Administration Basic Sciences Clinical Sciences Centers of Excellence
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Office of Medical Education
2020 Gravier Street
Suite 602
New Orleans, LA 70112
Phone: 504-568-4006
Fax: 504-599-1453

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Contemporary Ethical Issues in Clinical Medicine - Obstetrics & Gynecology 

L3 Clerkships

Joanne Cain Marier JD
Director, Program Health Law & Medical Ethics

Jaime Alleyn, MD
Clerkship Director, Obstetrics & Gynecology

6 weeks

  1. Laws governing practice of OBGYN in LA
  2. Sterilization
  3. Systems constraints on Optimal Care – Insurance Fraud
  4. Obstetrics - Case for discussion
  5. Fertility Medicine - Case for discussion

Louisiana Laws

Sterilization

Read Sterilization of Women: Ethical Issues and Considerations, ACOG Committee OpinionNumber 695, April 2017,  The American College of Obstetrics and Gynecology 
          https://www.acog.org/-/media/Committee-Opinions/Committee-on-Ethics/co695.pdf

Take Sterilization Quiz

Systems Constraints on Optimal Care- Insurance Fraud

Obstetrics – Case for discussion

Young adult female patient suffers unsurvivable gunshot wound.  As medical team is preparing to remove ventilatory support from patient, she is discovered to be 19-20 weeks pregnant.  Her parents request that their daughter be continued on ventilatory support until fetus is viable.  Statistically rate of survival is 25% at 23 weeks gestation and 75% at 25 weeks.  Would you continue patient on ventilator, if so for how long? Would you allow non viable fetus to “die” with mother?
  
Outline one issue and suggest how to proceed in 50 words.  Discuss case.

Fertility Medicine – Case for discussion

Patient delivers octuplets conceived with use of fertility drugs prescribed by licensed fertility physician.  She has six other children some of whom were conceived with and some without use of fertility drugs.  Would you provide fertility treatment to a patient who is not infertile?  Would you provide fertility treatment to a patient who has six other children?   Does it matter whether or not the mother has the means to support this many children?  Does the fact that the mother is a single parent change the decision?  What kind of screening process, if any, should a fertility practice adopt for patients who request fertility treatments?  Should ACOG develop a policy?  Should states enact laws to regulate?

Outline one issue and suggest how to proceed in 50 words.  Discuss case.