Avoid ‘cookbook medicine’ when reducing c-sections

Firm policies and procedures might be necessary to reduce cesarean rates, but resist the temptation to dictate every decision in the birthing process, says Samuel O. Southern, JD, an attorney with the law firm of Smith Moore Leatherwood in Raleigh, NC.

“The physician still has to rely on his best independent medical judgment as to what ought to be done,” Southern says. “You can’t have a cookbook medicine situation where The Joint Commission or any other external body is dictating to the physician when to do a c-section and when not to.”

In fact, the healthcare provider can be exposed to liability if it attempts to control the independent medical judgment of the practitioner, Southern says. When a birth ends tragically, the hospital can be held responsible if the practitioner or the plaintiff can show that a c-section should have been performed but the practitioner’s hands were tied by overly restrictive policies, he explains.

“When there is a conflict between the independent medical judgment of the physician and the standards of The Joint Commission, it is my opinion that the opinion of the physician is going to govern,” Southern says. “If The Joint Commission says there shall be no c-sections before 39 weeks, the physician still has to exercise his judgment to determine if that is appropriate for this patient.”