Running head: EMERGENCY CESAREAN

Pregnancy: Emergency Cesarean Section to Save Life

Alvin L. Rozier Jr.
College of Mount St. Joseph

Running head: EMERGENCY CESAREAN

Emergency Cesarean Section to Save Life

Early medical professionals have practiced Cesarean Section, as a medical procedure,
since ancient times. The main reason for this procedure was to separate the mother and the baby
if the mother had died before the baby was born naturally (Sewell, 1993). In present day
medicine, a cesarean section can be performed for a variety of medically necessary reasons. One
of those reasons is to save the life of not only the mother but the unborn infant as well as
presented in the summary of Case Study 2.
The Case presents with an expectant mother in the labor and delivery unit. The mother is
39 weeks gestation with the fetus in a transverse lie, which was subsequently verified by
ultrasound. Also noted were late decelerations of the fetuss heart rate, 7 centimeter cervical
dilation and the fetuss elbow as a presenting part. The couple was advised by the on call
obstetrician that an emergency cesarean section needed to be performed. Due to the nature of the
mothers pregnancy, advised the obstetrician, both the mother and the unborn fetus were at risk
of dying if the procedure was not done. Either party in the couple did not give informed consent:
they had vehemently denied it. The physician ordered the nurse to take the patient to the
operating room, begin an IV and notify the anesthetist to administer a general anesthesia. The
dilemma that exists in this situation is clearly one of ethics and malpractice.
In this situation one must consider the ethical and legal implications, of which there are
three, before making a decision to act. This decision must be almost instantaneous because time
is of the essence. The nurses decision, ethically, is based on placing the patient first and
advocating for the patients rights (Potter and Perry, 2013). Accordingly, the nurse has an
obligation to not carry out the order given by the physician because, ethically, it would be
incongruent with the code of ethics subscribed to by all nurse in the profession.

Running head: EMERGENCY CESAREAN

The second issue in this situation deals with the legality of not following orders. In most
other dealing with nurses this would constitute negligence, professional negligence or
malpractice (Potter and Perry, 2013). The physician on call gave an order for the nurse to follow.
Not acting in accord with this order could prove to have an undesirable affect on the pregnant
mother and the unborn child. If found negligent, by a disciplinary board for not following that
order, the nurse could face legal as well as psychological ramifications if the order given was not
followed.
Finally, the last issue in the situation deals with informed consent. Before any treatment
can be initiated by any care giver, the client that is to be the recipient of the care has to sign an
informed consent form agreeing to receive said care, in this case, a cesarean section. General
consent forms are usually signed upon admittance to the hospital. In the case study the couple
refused to sign an informed consent form. This action legally prevented the caregivers, in this
instance, the nurse and the physician from initiating any type of care. The only time an informed
consent can be waived is in the event of an emergency (Potter and Perry, 2013).
Herein lies the conundrum for the nurse at hand to analyze and render a decision on
which course of action to take. Ethically, the nurse is an advocate for the patients rights. In this
case the right to refuse care even if the ultimate end is death. Also, the rights of the unborn fetus
are at stake as well (Sewell, 1993). Legally, an order had been given to begin preparation for the
cesarean section, the refusal of which could be considered negligent if it causes harm to the
patient. That negligence could lead to malpractice and a civil lawsuit brought against the nurse
(Potter and Perry, 2013).
In conclusion, the author of this paper, having understood the ethical and legal
implications facing a nurse in the aforementioned case study, would act in accordance with the

Running head: EMERGENCY CESAREAN

obstetrician and carry out the order regardless of the unwillingness of the couple to not sign the
informed consent form and their wish to not have the procedure performed. This decision to
follow the order of the physician is in part three fold. In the case study there are two patients:
the mother and the unborn fetus. The author of this paper would advocate for the unborn babys
right to life in this emergency situation. The author would act in support of the physician because
a direct order was given. The noncompliance of the order would constitute negligence
subsequent to malpractice. Lastly, in an emergency situation, a caregiver does not need explicit
informed consent (Potter and Perry, 2013).

Running head: EMERGENCY CESAREAN

References
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2013). Fundamentals of Nursing (8th).
St. Louis, MO: Elsevier
Sewell, J.E. (1993). Cesarean sectiona brief history. Retrieved from

http://www.neonatology.org/pdf/cesarean.pdf

Running head: EMERGENCY CESAREAN