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innovations in everyday medical practice to humanitarian work in the field. It seems to me a cultural, a psychosocial block. If you talk about surgery , for example, in a humanitarian setting, immediately among many NGO workers their antibodies will rise. They will say, ‘That’s terrible, you can’t allow that Western, too high-tech surgery; it is inappropriate.’ But then if you say, ‘So, what about obstructed labour and interventions to save the mother and the child?’, then
the government won’t see the difference if it is us or ICRC providing the surgery and yet we don’t have the permanent ability to address the needs of non-war-wounded patients, such as obstetrics. Indeed, surgical care available to wounded combatants had been considered a trump card to obtain guarantees of respect and protection from the opposition’s leadership, whose soldiers, according to MSF-H’s head of mission
declined as a growing number of laymen began to practise as physicians, often men who had studied at one of the great medical schools in Continental Europe. Lay people were well established as surgeons. The Church’s ban on priests in the higher orders carrying out surgery created a space in which the ‘doctor’ practising surgery was free of clerical competition. Gradually the predominance of the priest
, feme sole , to determine whether or not to consent to any proposed surgery or treatment. The choice of what should, or should not, be done belonged to the patient and no privilege justified the doctor overriding his wishes or withholding information from him. Married women were less fortunate. While sharing the same rights vis-à-vis the surgeon as their husbands, married women were subject to the
‘artificial distinctions’ saying that ‘Medicine and Surgery must have been always, and are now understood by one and the same person’. Physicians needed to understand anatomy and surgery. Surgeons required a grasp of physiology. 2 Pelling and Webster comment that the ‘tri-partite division of labour was only imperfectly realised even in London’. 3 Outside London, R S Roberts concluded
demonstrated that this was not a valid test for all purposes: elective cardiac arrest during openheart surgery, for example, or cases of spontaneous cardiac arrest followed by successful resuscitation. The heart stops but the patient is not dead. Machines such as mechanical ventilators or respirators have effected major improvements in techniques of resuscitation and life support for those who are desperately ill or injured. Where these efforts are successful and the patients recover, one may praise the advances in medical techniques. Sometimes such measures do not provide
decision to perform spinal surgery on a minor who had been raped and attempted suicide, severely injuring herself. L.C. was also refused therapeutic abortion. Similar stereotypes operate to restrict access to contraception: pharmacists and health personnel in public dispensing have claimed, for example, their right to conscientious objection in refusing to accept requests for contraceptives and refusing to fill a doctor’s prescription of contraceptives.78 Conversely, involuntary sterilisation goes in the direction of denying women motherhood. The stereotype here sees the
5.1 There would be little support today, even from the most paternalistic doctor, 1 for the proposition that a sick adult should be compelled to accept whatever treatment his doctor thought best. No one suggests that adults who stay away from dentists out of childlike fear and to the detriment of their dental and general health should be rounded up and marched to the nearest dental surgery for forcible treatment. Few would deny the right of the adult Jehovah’s Witness to refuse a blood transfusion, 2 even if in doing so she forfeits her life. Medical
The book explores the relationship between violence against women on one hand, and the rights to health and reproductive health on the other. It argues that violation of the right to health is a consequence of violence, and that (state) health policies might be a cause of – or create the conditions for – violence against women. It significantly contributes to feminist and international human rights legal scholarship by conceptualising a new ground-breaking idea, violence against women’s health (VAWH), using the Hippocratic paradigm as the backbone of the analysis. The two dimensions of violence at the core of the book – the horizontal, ‘interpersonal’ dimension and the vertical ‘state policies’ dimension – are investigated through around 70 decisions of domestic, regional and international judicial or quasi-judicial bodies (the anamnesis). The concept of VAWH, drawn from the anamnesis, enriches the traditional concept of violence against women with a human rights-based approach to autonomy and a reflection on the pervasiveness of patterns of discrimination (diagnosis). VAWH as theorised in the book allows the reconceptualisation of states’ obligations in an innovative way, by identifying for both dimensions obligations of result, due diligence obligations, and obligations to progressively take steps (treatment). The book eventually asks whether it is not international law itself that is the ultimate cause of VAWH (prognosis).
decisions to withhold or withdraw treatment (even when agreed with parents) could subject them to possible criminal liability for murder or manslaughter. The fundamental principle governing withholding life saving treatment from young children was settled in Re B in 1981. An infant girl, Alexandra, was born suffering from Down’s syndrome and an intestinal obstruction. In a normal child, simple surgery would have been carried out swiftly with minimal risk to the baby. Without surgery, the baby would die within a few days. Her parents refused to authorise the operation