Georgina

Georgina is a 16-year-old admitted to the ER with pre-term labor.  Ultrasound reveals that she is 32 weeks pregnant, and upon clinical exam it is determined she is 4 cm dilated.  The emergency physician immediately institutes tocolytic drugs to stop the contractions and stem off labor for a time and also administers corticosteroids to strengthen the baby’s lungs in the event that the baby is delivered early.  The OBGYN on call is consulted and requests that the woman be brought to the labor & delivery unit.  After reviewing the patient’s ultrasound, the OBGYN notes that the baby is in a breech position, which means that a cesarean section will most likely be required.  Despite tocolysis, the girl’s labor continues to progress and fetal monitoring shows that the baby is experiencing significant fetal distress.  The OBGYN informs Georgina that an emergency c-section will have to be done to save the baby.  Georgina, however, states that she “does not want to be cut into” and refuses to give her consent for the procedure.  The OBGYN explains that time is of the essence if the baby is to have the best outcome but Georgina is adamant no c-section be performed.  The OBGYN insists that it must be done and the Georgina’s grandmother, who has been with her since entering the ER, intervenes and says “my granddaughter has made her wishes known.”  Furious, the OBGYN states that “the baby will likely die or be severely impaired if a c-section is not done stat.”  Georgina’s grandmother does not give in, however, and says if anything is done against her granddaughter’s wishes, she will bring suit against the OBGYN and the hospital.