IMPORTANCE OF MEDICAL ETHICS AND DOCUMENTATION IN OBSTETRICS & GYNAECOLOGY

IMPORTANCE OF MEDICAL ETHICS AND DOCUMENTATION IN OBSTETRICS & GYNAECOLOGY

• Obstetrics and Gynaecology involve highly sensitive and intimate aspects of a woman’s health.

• Ethical conduct and proper documentation ensure patient safety, autonomy, trust, and legal safeguarding of both patient and practitioner.

• Classical Ayurvedic texts also stress the importance of ethics and accountability in physician conduct.

IMPORTANCE OF MEDICAL ETHICS

DEFINITION OF MEDICAL ETHICS

• Medical ethics refers to the principles and guidelines that govern the behavior of healthcare providers toward their patients, society, and profession.

ETHICAL PRINCIPLES IN OBSTETRICS & GYNAECOLOGY

• Autonomy – Respecting the patient’s decision-making rights in reproductive choices, contraception, labour management, etc.

• Beneficence – Acting in the best interest of the mother and fetus.

• Non-maleficence – Avoiding harm through informed procedures like episiotomy, caesarean section, etc.

• Justice – Providing equal care irrespective of socio-economic status, caste, religion, etc.

• Confidentiality – Keeping patient records, HIV status, abortion history, and sexual health private.

AYURVEDIC ETHICAL GUIDELINES

• Ethics in Ayurveda are well defined under the role of Vaidya Dharma.

• The physician should be of shuddha acharana, dayalu, and nishkaama.

SANSKRIT REFERENCE
सुश्रुतसंहिता सूत्रस्थान 1/15
“शौचं दया दाक्ष्यं विज्ञानेऽभ्यास आसक्तिः |
शास्त्रेषु शक्तिर्भवति चिकित्सकस्य ||”
(Meaning: A physician must possess cleanliness, compassion, skill, dedication to knowledge, and expertise in the science.)

MODERN ETHICAL ISSUES IN OBSTETRICS & GYNAECOLOGY

• Female feticide and sex-selective abortions.

• Consent in caesarean section or hysterectomy.

• Surrogacy, IVF, and donor insemination ethics.

• Termination of pregnancy (MTP Act).

• Teenage pregnancies and decision-making autonomy.

• Ethical dilemmas in emergency obstetric care.

IMPORTANCE OF MEDICAL DOCUMENTATION

DEFINITION OF MEDICAL DOCUMENTATION

• The systematic recording of patient history, clinical findings, diagnostic test results, treatment plans, operative notes, and discharge summaries.

AYURVEDIC INSIGHT ON DOCUMENTATION

• Though traditional Ayurveda was orally transmitted, documentation was emphasized in terms of "tantrayukti", "pramana", and systematic case descriptions.

SANSKRIT REFERENCE
चरकसंहिता सूत्रस्थान 30/26
“दृष्टं श्रुतं अनुभूतं युक्त्युपलब्धं च यद्भवेत् |
तच्च चिकित्सायां युक्तं तत्सर्वं धर्म उच्यते ||”
(Meaning: That which is seen, heard, experienced, or logically inferred is the foundation of righteous practice and documentation.)

NEED FOR DOCUMENTATION IN OBSTETRICS & GYNAECOLOGY

• To maintain medical and legal accountability.

• To ensure continuity of care across obstetric and gynaecological stages.

• For proper record of antenatal, intrapartum and postnatal care.

• To document consent before surgical interventions like caesarean, hysterectomy, tubectomy.

• Helps in medicolegal defense in maternal or fetal mortality.

• Important in research, audits, and insurance.

• For public health data collection – maternal mortality rate, fertility statistics, etc.

IMPORTANT DOCUMENTS IN OBG PRACTICE

• Case sheet

• Consent form

• Partograph

• MTP and abortion record

• Ultrasound reports

• Histopathology reports

• Family planning registers

• Birth and death certificates

• Neonatal record

MODERN REFERENCE (BASED ON STANDARD TEXTBOOKS)

• As per DC Dutta’s Textbook of Obstetrics and Gynaecology, medical documentation is crucial for:

  • Informed consent

  • Risk-benefit explanation

  • Proper history-taking and examination record

  • Accurate reporting of investigations and treatments

  • Labour room documentation (Partograph)

  • Operative notes and post-operative instructions

  • MTP Act compliance

  • Medico-legal case documentation

LEGAL AND ETHICAL LAWS RELATED TO OBG

• MTP Act, 2021 – Permits abortion up to 24 weeks under specific conditions.

• PCPNDT Act, 1994 – Prevents sex determination and female feticide.

• Surrogacy (Regulation) Act, 2021

• ART Regulation Act, 2021

• Consent under Indian Penal Code Section 87, 88, and 89 – Applicable in OBG surgeries.

• Medical Negligence and Compensation Law – Case reference: Samira Kohli vs Dr. Prabha Manchanda.