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marvel

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Protecting Potential Children?
Posted: 03-01-08 15:45pm

There's a lawsuit happening right now in Ontario that is creating a bit of a buzz.

A married couple decided it best for the husband to get a vasectomy. Upong having this done, the wife decided to take care of her acne by going to the doctor and getting a prescription for Accutane.

If a woman in the early stages of pregnancy takes accutane, the fetus can experience serious physical and neurological side effects.

As it turns out, the woman ended up getting pregnant (Vasectomies aren't 100% successful). Her daughter ended up having severe nerve and physical facial deformities as a result.

They are suing the doctor who prescribed her the accutane, because he didn't properly advise the woman to use a condom or other birth control, even though her husband had a vasectomy.

This raises and interesting question: Are doctors obligated to a duty of care to children that don't exist yet? Is it a doctor's responsibility, or is it the patient's?

Source: http://www.th estar.com/News/Ontario/article/308456
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Birch

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Posted: 03-01-08 16:26pm

"... it will be the first time an appeal court in Canada has recognized a doctor has a duty of care to a child not yet conceived."


And...

"This could include refusing to provide girls and women of child-bearing age – theoretically 11 to 60 – with drugs that may pose dangers to a future child, including cancer drugs, unless there's proof birth control is being used."

And...

"..."What are (doctors) supposed to do? Put them on polygraphs?""

And...

"They argue that what Jaime, in essence, is saying is: "You shouldn't have given my mother Accutane without ensuring she would use a condom. Had you done this, I would not have been born.""

So we've got this whole feminism-empowerment movement going on, and then this kind of scenario comes along and sets it back.

I'm sorry that happened to her daughter, but it ain't the doc's fault. Maybe she should be suing the makers of Accutane so they are inclined to produce medication without harmful side effects. Or she could sue the genie at the fair for not predicting the future. I think the drug company's a better choice.
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Darkmoon

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Posted: 03-01-08 16:28pm

I think he should have given her information concerning how it might affect a pregnancy, but as far as patient care goes I strongly feel that the woman's health interests should come first (meaning that while doctors should inform patients beforehand of dangerous treatment, they should not refuse or delay giving superior treatment of an ailment to a female patient because it might harm a fetus that may or may not exist).

The onus of information is on the doctor...the onus of proceeding with the treatment is on the woman. I consider both parties in the above case in the wrong and equally to blame. The couple is suing the doctor for giving treatment that THEY REQUESTED in the first place, and the doctor failed to give them significant information about the treatment beforehand.
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Cambion

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Posted: 03-01-08 16:43pm

I think if the medication can cause birth defects, the doctor is obligated to let the patient know. If she's got that warning, it's up to her if she wants to take the risk...and if she does, then it's not the doctor's fault.
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sillyakchick

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Posted: 03-01-08 19:03pm

First off, I am 100% certain that the makers of accutane include the information regarding serious side effects to unborn children in their leaflets that are there for patient protection. Usually giving a patient accutane means they have had "the talk" with the doc, and since she had a dh with vasectomy, odds were pretty small that she'd of had a pregnancy in the first place. She Should have been advised about what would happen when the pregnancy was discovered. It's too bad that it happened that way, but it's nobody's ffault except fate. Maybe this is a smokescreen for the rreal reason she got pregnant-maybe it wasn't her husband. Who knows. I get really tired of people being litigation-happy!
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marvel

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Posted: 03-02-08 16:15pm

I would think that the pharmacist also briefed the patients on the effects of the drug they were taking (it's compulsory here). So I don't think they were ignorant to the whole situation.

I just think the question is interesting, and the one at hand: Do doctors have to provide duty of care to someone not yet conceived... in any circumstance? Is the 'potentiality' of human life important enough to warrant physician care?

I don't think so.
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killbill

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Posted: 03-03-08 16:21pm

I've heard that if you get a vasectomy you really should get sperm counts done to make sure it is actually going to prevent pregnancy, especially in the first month after it's done. We were talking about this in our mothers' group today and the PHN said that most vasectomy pregnancies occur when the couple resumes sex without protection before getting a sperm count done to check if the vasectomy was successful. I wonder if that's what happened in this case. I'm sure her doctor must have informed her of the danger since it is so serious. The couple should also have been informed of possibility of failure of the vasectomy and taken the appropriate steps to prevent the pregnancy.
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Verizon-y

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Posted: 03-03-08 22:04pm

She should be suing the doctor who did the vasectomy and didn't warn them that it might not be 100%, that they needed a sperm count, etc., etc.
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Tylanas

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Posted: 03-03-08 23:04pm

You legally HAVE to sign a waiver SAYING you'll use two forms of birth control!! You HAVE to legally get "the talk". If the doctor didn't do this, then he is in trouble in more ways than one - because that waiver and talk means the patient CANNOT sue the doctor or the hospital if they do end up pregnant, because they signed a waiver saying "Yes, I know this medicine is very potent".

How on Earth did this woman get Accutaine without signing that waiver? Did she sign and not read? Did she not receive the half-dozen pamphlets I had to read? I mean dear god, there's an actual BOOK, about a foot tall and a foot wide and two inches thick with nice big pictures and glossy pages telling you DO NOT GET PREGNANT - BAD THINGS HAPPEN!!!

If anyone should be sued, I suppose it's the doctor but honestly, no one is really at fault here.
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Tylanas

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Posted: 03-03-08 23:05pm

marvel wrote:
I would think that the pharmacist also briefed the patients on the effects of the drug they were taking (it's compulsory here). So I don't think they were ignorant to the whole situation.

I just think the question is interesting, and the one at hand: Do doctors have to provide duty of care to someone not yet conceived... in any circumstance? Is the 'potentiality' of human life important enough to warrant physician care?

I don't think so.

Absolutely not. A doctor deals with LIFE, not potential life.
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Tylanas

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Posted: 03-04-08 01:52am

Here's a link to another article relating to this case.

ht tp://www.cbc.ca/health/story/2004/02/26/ac cutane040226.html

"Paxton said her doctor never gave her the educational material that is supposed to come with every Accutane prescription.

"He did not give it to me," said Paxton. "The prescription itself did have an information package, but I didn't look at it."

At Toronto's Hospital for Sick Children, Dr. Gideon Koren is tracking babies born to women taking Accutane. He says none of the 11 women in his study received the complete educational package required by Health Canada."

So this is partly her doctor's fault and partly HER fault too.
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Verizon-y

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Posted: 03-04-08 02:55am

That is tragic that so many doctors screwed up like that.
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Tylanas

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Posted: 03-04-08 10:26am

I know. More and more I hear about people with terrible doctors. I can't imagine how I made it through my youth with good ones!! Must be that government health care.
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antigone

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Posted: 03-06-08 01:47am

It is the physician's responsibility to provide the necessary educational materials and verbal instructions about medication.
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Birch

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Posted: 03-06-08 12:00pm

"He did not give it to me," said Paxton. "The prescription itself did have an information package, but I didn't look at it."

So if the doc gave her the info (and maybe they did, who knows) would she have even read it or listened to him?

I think her motivations are questionable.

There is a point where people are responsible for themselves. I never take medication until reading about it thoroughly, regardless of what a doctor says. They could be in the pharmeceutical company's pocketbook. Or have some other underlying motivation. Or just be flat out wrong.

Since this lawsuit was filed in the daughter's name by the parents, isn't the daughter in effect charging that the doc should have told her mom to use a condom to ensure that she never be born? How is that protecting potential life?

I still say sue the pharm co. for Accutane (Roche) for providing a medication with serious and harmful effects.

Does anyone know when in her pregnancy she stopped taking the medication?
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Verizon-y

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Posted: 03-06-08 12:49pm

How many people have ever read the inserts that occasionally come with their prescriptions?
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Tylanas

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Posted: 03-06-08 13:16pm

I read the information provided with Accutane because it was stressed to me how dangerous the drug was. I was put on birth control for one month before I could start it, and used that month to see if I could clear up my face on my own. Due to the risk of depression and the other side effects, I decided not to go on it. Plus, my own routine had worked to get rid of my acne.
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