Laura Hart responded to Kathy D that,

<< Unfortunately our hospital policy states that we must do a
 blood sugar on EVERY baby. When I talked to my grandson's pediatrician about
 refusing to do the blood sugar (he had NO risk factors) she said that it was
 too risky in today's litigious environment not to follow policy. >>


This is like other cases of hospital policy that may or may not be in baby's
best interests.  "Must do a blood sugar" means, "must plan to do a blood
sugar, subject to parents signing the informed consent form," doesn't it?  I
can't believe they are going to go to court to enforce this policy if the
baby is thriving!   Laura was trying to get the doc to refuse to do the test,
if I understood her correctly, but I can't believe that they would do it
without a consent.  If parents are willing to go to the mat over something
like this -- to say, If you do this I will check out my baby right now AMA
(against medical advice) -- then they can often prevent it.

But (even though I have myself said these very words on at least two
occasions) I am not sure that net public health will be served by encouraging
parents and patients to say this to hcps very often.   Folks who work in
hospitals have a very different perspective from lay people, and while it
includes some things I hate -- like overdependence on rigid protocols and
what is perceived as litigation-prevention --it also includes awareness of a
lot of genuine risks that are unknown to most parents.   So I am deeply
ambivalent about this.

Overall, I think the best thing is intensive education, both of parents (and
prospective parents, meaning all of society!) and of health personnel.  If
Travis's pediatrician had seen it as a greater litigation risk to give the
baby potential formula allergens that to flirt with a blood sugar of 39, she
would not have had this conversation.

And yet I myself don't hesitate, in areas where I am confident and
knowledgeable about what constitutues good care, to tell doctors and others
to get their darn hands the heck off my kid!   Or conversely, check this out
now even if you think I'm a hysteric because otherwise your malpractice
insurers will wish you had!   This whole area is really a delicate dance,
isn't it...

Elisheva Urbas, NYC

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