29 January 2011

But We Must Do Something!

Maybe it's just me, but it seems that sometimes in medicine (thinking specifically of maternity/intrapartum/neonatal) the reason for doing something seems to be for the sake of doing something.  Maybe there's really a problem, maybe not, but the default often seems to be to do something, anything.  Now, I'm not saying action isn't sometimes justified, because it is, and I'm very grateful for modern medicine.  However, it seems to me, bearing in mind that I have no medical training, that it makes more sense to do nothing until and unless action is indicated.  Shouldn't we have to justify taking an action, instead of justifying not taking an action?  This is one reason I'm in favour of delayed cord clamping (see this page for Dr Nicholas Fogelson's thoughts on this), against routine infant circumcision, against continuous foetal monitoring, in favour of the woman getting to move around and eat and drink during labour as she wishes, in favour of a natural delivery of the placenta, etc.  Surely the default should be to leave the body alone unless it can be shown that an intervention is truly beneficial?  And that interventions shouldn't be used 100% of the time?  When interventions are indicated, I also feel that the least amount of intervention that will accomplish the goal should be used.  After all, we don't want to make McCoy's mistake when he was overly aggressive in treating Spock and temporarily blinded him.

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