RESUMO
Up to 2% of pregnant women develop a disease that requires nonobstetrical operative intervention during pregnancy. We discuss the issues unique to pregnant patients as they pertain to the presentation, diagnosis, and management of nonobstetric surgical disease, with an emphasis on 2 of the most common diseases that affect pregnant women: appendicitis and cholecystitis. Surgery has been demonstrated to be safe and effective during pregnancy, provided proper precautions are taken into account. It is the consensus of multiple professional committees and societies that no pregnant women should be delayed or denied a necessary surgery because of pregnancy.
Assuntos
Apendicectomia , Apendicite , Colecistectomia , Colecistite , Complicações Pós-Operatórias , Complicações na Gravidez , Risco Ajustado/métodos , Apendicectomia/efeitos adversos , Apendicectomia/métodos , Apendicite/diagnóstico , Apendicite/cirurgia , Colecistectomia/efeitos adversos , Colecistectomia/métodos , Colecistite/diagnóstico , Colecistite/cirurgia , Diagnóstico por Imagem/métodos , Medicina Baseada em Evidências , Feminino , Humanos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/cirurgia , Tempo para o TratamentoRESUMO
Contrasting traditional and common forms of ethics consultation with bioethics mediation, I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, led to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care.
Assuntos
Tomada de Decisão Clínica/ética , Conflito de Interesses , Eticistas/educação , Consultoria Ética , Negociação/métodos , Assistência Centrada no Paciente/ética , Assistência Terminal/ética , HumanosRESUMO
Contrasting traditional and common forms if ethics consultation with bioethics mediation. I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, let to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care.