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Allegation of Forced C-Section Fuels Debate Over Women's Medical Autonomy

Allegation of Forced C-Section Fuels Debate Over Women's Medical Autonomy

May 19, 2014 — A lawsuit alleging that doctors at a New York hospital forced a woman to undergo a cesarean section against her will sheds light on broader debates over the nation's high rate of surgical deliveries and the rights of pregnant women to select their mode of delivery, even if physicians believe it may endanger the fetus, the New York Times reports.

According to the Times, roughly 33% of births in the U.S. are c-sections, far exceeding the World Health Organization's recommendation that c-sections account for no more than 10% to 15% of births. The U.S. rate has been increasing since 1996, despite warnings from health officials that the procedure is associated with health risks for both women and infants.

Case Details

The New York case involves Rinat Dray, who presented for care at Staten Island University Hospital in July 2011 with her third pregnancy, stating a desire to deliver vaginally. However, Dray eventually delivered her third child via c-section after several hours of labor and arguing with the doctors, who said a c-section was needed to protect the fetus, according to the Times.

Dray filed suit in the New York Supreme Court in Brooklyn, alleging that the hospital and its physicians "improperly substitut[ed] their judgment for that of the mother" and tried to persuade her by "pressuring and threatening" her during labor.

The hospital declined to comment because of patient privacy and the ongoing litigation. However, physician Leonid Gorelik -- who delivered Dray's infant and is a defendant in the case -- said in court papers that he did not perform the procedure against her will and that any injuries she sustained during treatment were because of her own "culpable conduct and want of care." Dray's bladder was cut during the c-section.

Meanwhile, James Ducey, another physician at the hospital and defendant, wrote in the medical record that the fetus was "at ris[k] for serious harm without the C-section." Hospital records show that Ducey in a handwritten note said that he "decided to override [Dray's] refusal to have a C-section."

Expert: Right To Refuse Should Be 'Uncircumscribed'

Howard Minkoff -- chair of obstetrics at Maimonides Medical Center in New York, who has written published articles on patient autonomy -- said women should have the right to refuse treatment even if the decision causes fetal death.

"In my worldview, the right to refuse is uncircumscribed," he said, adding, "I don't have a right to put a knife in your belly ever" (Hartocollis, New York Times, 5/16).