+ Medical Ethics in O&G Dr. Anna Stienen-Durand ST3 O&G, RSCH

+ Medical Ethics Until Now…. Informed consent Capacity Confidentiality Clinical negligence

+ Medical Ethics in O&G Death and stillbirth certification Termination of pregnancy

+ Death and Stillbirth Certification Stillbirth or neonatal death Maternal death Death occurring on the gynaecology wards

+ Reporting a Death to the Coroner Maternal death after TOP or miscarriage After an operation Child born alive at any stage of pregnancy and then died

+ Post Mortem Provide significant information about cause of death in % of cases Provide information for future pregnancies Complete/limited/external post mortem Tissue samples

+ Termination of Pregnancy HSA1 form Medical TOP Surgical TOP

+ Conscientious Objection Doctors may refuse to participate in terminations but are obliged to provide necessary treatment in an emergency when the woman's life may be jeopardised Doctors with a conscientious objection may not impose their views on others but may explain their views to a woman if invited to do so Refusal to participate in paperwork or administration connected with abortion procedures lies outside the terms of the conscientious objection clause Practitioners cannot claim exemption from giving advice or performing the preparatory steps to arrange an abortion where the request meets the legal requirements. Have a duty of care to refer a woman requesting a TOP onwards. The clause may be used by medical students to opt out of witnessing abortions

+ Useful Information ‘Deciding on a post mortem examination-Information for parents’ SANDS The Care of Women Requesting Induced Abortion Evidence based clinical guideline number 7, RCOG Department of Health website StratOG learning modules Trust protocols

+ Summary Stillbirth certification Reporting cases to the coroner Post mortem Termination of pregnancy Conscientious objection to TOP