The Legal Effects of Fetal Monitoring Guidelines

International Journal of Gynecology and Obstetrics, Vol. 108, pp. 170-173, 2010

4 Pages Posted: 2 Dec 2010

See all articles by Bernard Dickens

Bernard Dickens

University of Toronto - Faculty of Law

Rebecca J. Cook

University of Toronto - Faculty of Law

Date Written: November 1, 2010

Abstract

The new American College of Obstetricians and Gynecologists’ (ACOG) monitoring guidelines introduce a new category of interpretation of fetal heart rate tracings between reassuring and nonreassuring, namely intermediate. The purpose is to reduce unnecessary cesarean deliveries. The legal role of medical guidelines is ambivalent. Providers are expected to be familiar with such guidelines, but also to exercise clinical judgment in their patients’ interests. Practice departing from guidelines requires justification, but simple compliance without regard to patients’ circumstances may constitute negligence. Some courts defer to medical professional guidelines, but others hold that professional standards are set as a matter of law, not by the profession itself. Unlike conclusions in medical science, which are open to continuing review, courts determine facts in a case only once, at trial. Litigation to compel patients’ compliance with medical advice based on guidelines may fail, as may prosecutions, more common in the US, of patients who defy such advice.

Keywords: Cerebral Palsy, Clinical Judgment, Fetal Monitoring Guidelines, Guidelines, Legal Evidence, Perinatal Mortality, Refusal of Advice

JEL Classification: I18, K1, K4, K19

Suggested Citation

Dickens, Bernard and Cook, Rebecca J., The Legal Effects of Fetal Monitoring Guidelines (November 1, 2010). International Journal of Gynecology and Obstetrics, Vol. 108, pp. 170-173, 2010, Available at SSRN: https://ssrn.com/abstract=1718475

Bernard Dickens (Contact Author)

University of Toronto - Faculty of Law ( email )

78 and 84 Queen's Park
Toronto, Ontario M5S 2C5
Canada
416-978-4849 (Phone)
416-978-7899 (Fax)

Rebecca J. Cook

University of Toronto - Faculty of Law ( email )

78 Queen's Park Cr.
Toronto, Ontario M5S 2C5
Canada
416-978-4446 (Phone)
416-978-7899 (Fax)

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