Actual ethical and legal aspects about caesarian section

L. Pleș, R.M. Sima, A.D. Stănescu

Rezumat: Introduction. Proportion of births completed by caesarean section is increasing not only in Romania but also in US and other European countries (the official data on caesarean rate in Romania are not consistent). Methods. Increasing incidence is linked rather to the lack of health education of the population, fear of litigation from obstetricians and expansion of private practice, than to pathology or indications that drastic change. Results. Disputes concerning obstetrics registered at the Medical College from Bucharest between 2011 and 2015 totaled 68 cases out of 598 detained for investigation and 1/10 were linked to general surgery. 49 cases of these have dealt with assistance at birth or pregnancy monitoring. There were detained 22 cases in which patients complained that caesarean section was not performed. The performing of C-section wasn’t incriminated in any detained case. Analyzing the incidents, there are a number of rules of the Penal Code, Patient Rights Act, Code of Medical Deontology of the Medical College of Romania, and the Ministry of Health Protocol practice of caesarean section. The ethical aspects of caesarean section are represented by the principles of maternal and fetal beneficence, non-maleficence, and autonomy. Conclusions. Caesarean section on demand is another controversial ethical and legal issue that requires a consensus of obstetricians guaranteed by the Romanian Society of Obstetrics and Gynecology.
Cuvinte cheie: cesarian on demand, Penal Code, obstetrics, iatrogeny.