– The basic principle of medical treatment is the patient’s well-being. But we are always aware that we can be treated like criminals, punished with a criminal sentence and sent to prison. And this is not conducive to our actions – says Prof. Mariusz Zimmer, president of the Polish Society of Gynecologists and Obstetricians.
- Each medical case must be considered individually, but prof. Mariusz Zimmer, president of the Polish Society of Gynecologists and Obstetricians, has no doubts that the judgment of the Constitutional Tribunal, which tightens the abortion regulations, has an impact on the thinking and conduct of doctors
- The new law, according to prof. Zimmer, “does not ensure peace and trust between the patient and the doctor”
- The doctor predicts a sad future. – Nobody wants to risk such criminal liability and deal with obstetrics. It is scary, because in a moment we will not have maternity hospitals with doctors – says the professor
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Diana Szwajcer, Onet: According to media reports, the patient who died in Pszczyna was diagnosed with anhydrous and the fetus had congenital defects. What is the recommended procedure for dealing with this situation?
Prof. Mariusz Zimmer: “According to media reports”, because we do not have any certain medical data, and they are the most important. Medicine is a very complicated art, so each case should be treated individually. There is no rule of thumb for every patient or even every disease entity.
We are talking about the drainage of the amniotic fluid, but we do not know from when. We are talking about fetal defects, but we don’t know which ones. And these parameters determine the procedure and how the patient related to it. Medical management is based on some kind of recommendations, including Society of Gynecologists and Obstetricians, of which I am the president. These set the course of action, not a strictly defined course of action in a given case. I can not say about the recipe for a grandmother – let’s pour it into it, mix it up and it will be a grandmother. The art of healing doesn’t work that way.
So, deviating from the specific case, are there any specific guidelines for anhydrousness or other problems in pregnant women?
In addition to a smaller amount of amniotic fluid, the outflow of amniotic fluid, there are many other fortifications that determine the procedure. It cannot be said that it is necessary to stop pregnancy, it cannot be said that we are keeping the pregnancy, we are holding it until this week, we are giving birth the way it is.
Some say that the death of the patient from Pszczyna would not have happened without the tightening of abortion regulations. Did last year’s judgment of the Constitutional Tribunal change anything in the treatment of patients with such problems?
The most important principle of medicine is to heal and take care of the patient’s health. Now we have at the back of our heads that our every procedure, despite the fact that it will be directed with the greatest care to help the patient, can always end in failure. The fact that there is a law that says that there is a risk of criminal liability for this does not help with proper treatment. It does not provide peace and trust between the patient and the doctor.
I feel sorry for the patients above all. Because we could do something to help, and then someone will accuse us of having terminated the pregnancy. Certainly, this sentence is not conducive to normal medical action and is also not conducive to the progress of medicine. If we do not use new technologies, we will stop in place, and that is tantamount to going backwards. Unfortunately, this judgment is holding us back. I am thinking in particular of prenatal diagnostic procedures and prenatal procedures. The judgment of the Constitutional Tribunal is a huge blow to progress in this regard.
Until the judgment of the Constitutional Tribunal, Poland was regarded as one of the leaders in countries dealing with prenatal research and treatment. It was a glory and honor for Poland gynecology.
We listen to our colleagues from the West, how they perform various procedures that are performed intrauterineally on the fetus, now we have concerns that this procedure will not be treated as a procedure that promotes abortion, miscarriage, and this, as you can see, is punishable in our country. And it is terrifying.
- Doctors waited three days for the fetus to die. «Sorry it took us so long»
There are voices that as a result of the judgment of the Constitutional Tribunal, pregnancies with no chance of survival and potentially endangering a woman are often not terminated until a woman’s life is immediately threatened or the fetus dies. Doctors at the back of the head have concerns, but can you say there is a “chilling effect” of the sentence – doctors fear the prosecutor more than the risks to the patient of maintaining the pregnancy?
The basic principle of medical treatment is the patient’s well-being. But we are always aware that we can be treated as criminals, punished by criminal law and sent to prison. And it is not conducive to our actions. It is also not conducive to the development of obstetrics and recruitment of medical staff. Nobody wants to risk such criminal liability and deal with obstetrics. This is scary, because in a moment we will not have maternity hospitals with doctors. It has to be stopped.
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Now we have enough gynecologists and obstetricians?
Not. This situation has been going on for some time.
Young doctors choose other specialties, less risky and less responsible. We struggle with job vacancies in hospitals, especially in highly specialized ones, where nobody wants to work.
We were at the forefront of prenatal research and treatment. Will we have a chance to come back to it?
How the law will change. Unfortunately, I don’t see anything changing. None of us will risk our life, reputation, or criminal liability to undertake difficult, risky gynecological and obstetric procedures. And without them our patients suffer and are not treated in the same way as in the civilized world.
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