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The Limits of Conscientious Refusal in Reproductive Medicine

Committee Opinion Number 385, November 2007

Reaffirmed 2016

ABSTRACT Health care providers occasionally may find that providing indicated even standard care would present for them a personal moral problema conflict of conscienceparticularly in the field of reproductive medicine Although respect for conscience is important conscientious refusals should be l...

November 2007

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Vaginal "Rejuvenation" and Cosmetic Vaginal Procedures

Committee Opinion Number 378, September 2007

(Reaffirmed 2014)

ABSTRACT Socalled vaginal rejuvenation designer vaginoplasty revirgination and Gspot amplification are vaginal surgical procedures being offered by some practitioners These procedures are not medically indicated and the safety and effectiveness of these procedures have not been documented Clinicia...

September 2007

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Nalbuphine Hydrochloride Use for Intrapartum Analgesia

Committee Opinion Number 376, August 2007

(Reaffirmed 2014)

ABSTRACT Safety concerns have been raised regarding the use of nalbuphine hydrochloride during labor The American College of Obstetricians and Gynecologists finds data are insufficient to recommend any changes in nalbuphine hydrochloride administration at this time Opinion Nalbuphine hydrochloride...

August 2007

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Brand Versus Generic Oral Contraceptives

Committee Opinion Number 375, August 2007

(Reaffirmed 2015)

ABSTRACT The US Food and Drug Administration considers generic and brand name oral contraceptive OC products clinically equivalent and interchangeable The American College of Obstetricians and Gynecologists supports patient or clinician requests for branded OCs or continuation of the same generic ...

August 2007

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Expert Testimony

Committee Opinion Number 374, August 2007

Reaffirmed 2016

ABSTRACT It is the duty of obstetricians and gynecologists who testify as expert witnesses on behalf of defendants the government or plaintiffs to do so solely in accordance with their judgment on the merits of the case Obstetriciangynecologists must limit testimony to their sphere of medical expe...

August 2007

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Sexual Misconduct

Committee Opinion Number 373, August 2007

Reaffirmed 2016

ABSTRACT The physicianpatient relationship is damaged when there is either confusion regarding professional roles and behavior or clear lack of integrity that allows sexual exploitation and harm Sexual contact or a romantic relationship between a physician and a current patient is always unethical...

August 2007

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Sterilization of Women Including Those With Mental Disabilities

Committee Opinion Number 371, July 2007

Reaffirmed 2016

ABSTRACT Sterilization like any other surgical procedure must be carried out under the general ethical principles of respect for autonomy beneficence and justice Women requesting sterilization should be encouraged to discuss their decision and associated issues with their husbands or other appropr...

July 2007

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Institutional Responsibility to Provide Legal Representation

Committee Opinion Number 370, July 2007

(Reaffirmed 2015)

ABSTRACT Hospitals academic institutions professional corporations and other health care organizations should have policies and procedures by which alleged violations of professional behavior can be reported and investigated These institutions should adopt policies on legal representation and inde...

July 2007

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Seeking and Giving Consultation

Committee Opinion Number 365, May 2007

Reaffirmed 2016

ABSTRACT Consultations usually are sought when practitioners with primary clinical responsibility recognize conditions or situations that are beyond their level of expertise or available resources One way to maximize prompt effective consultation and collegial relationships is to have a formal con...

May 2007

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Patient Testing Ethical Issues in Selection and Counseling

Committee Opinion Number 363, April 2007

(Reaffirmed 2015)

ABSTRACT Recommendations to patients about testing should be based on current medical knowledge a concern for the patients best interests and mutual consultation In addition to establishing a diagnosis testing provides opportunities to educate inform and advise The ethical principles of respect fo...

April 2007

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Commercial Enterprises in Medical Practice

Committee Opinion Number 359, January 2007

(Reaffirmed 2015)

ABSTRACT Increasing numbers of physicians sell and promote both medical and nonmedical products as part of their practices Physicians always have rendered advice and treatment for a fee and this practice is appropriate It is unethical under most circumstances however for physicians to sell or prom...

January 2007

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Innovative Practice: Ethical Guidelines

Committee Opinion Number 352, December 2006

(Reaffirmed 2015)

ABSTRACT Innovations in medical practice are critical to the advancement of medicine Good clinicians constantly adapt and modify their clinical approaches in ways they believe will benefit patients Innovative practice frequently is approached very differently from formal research which is governed...

December 2006

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Amnioinfusion Does Not Prevent Meconium Aspiration Syndrome

Committee Opinion Number 346, October 2006

(Reaffirmed 2016)

ABSTRACT Amnioinfusion has been advocated as a technique to reduce the incidence of meconium aspiration and to improve neonatal outcome However a large proportion of women with meconiumstained amniotic fluid have infants who have taken in meconium within the trachea or bronchioles before meconium ...

October 2006

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Mode of Term Singleton Breech Delivery

Committee Opinion Number 340, July 2006

(Replaces No. 265, December 2001, Reaffirmed 2016)

ABSTRACT In light of recent studies that further clarify the longterm risks of vaginal breech delivery the American College of Obstetricians and Gynecologists recommends that the decision regarding mode of delivery should depend on the experience of the health care provider Cesarean delivery will ...

July 2006

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Analgesia and Cesarean Delivery Rates

Committee Opinion Number 339, June 2006

(Reaffirmed 2016, Replaces No. 269, February 2002)

ABSTRACT Neuraxial analgesia techniques are the most effective and least depressant treatments for labor pain The American College of Obstetricians and Gynecologists previously recommended that practitioners delay initiating epidural analgesia in nulliparous women until the cervical dilatation rea...

June 2006

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Elective Coincidental Appendectomy

Committee Opinion Number 323, November 2005

(Reaffirmed 2014, Replaces No. 164, December 1995)

ABSTRACT Because of a lack of evidence from randomized trials it remains unclear whether the benefits of routine elective coincidental appendectomy outweigh the cost and risk of morbidity associated with this prophylactic procedure Because the riskbenefit analysis varies according to patient age a...

November 2005

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Screening for Tay - Sachs Disease

Committee Opinion Number 318, October 2005

(Reaffirmed 2014, Replaces No. 162, November 1995)

ABSTRACT TaySachs disease TSD is a severe progressive neurologic disease that causes death in early childhood Carrier screening should be offered before pregnancy to individuals and couples at high risk including those of Ashkenazi Jewish FrenchCanadian or Cajun descent and those with a family his...

October 2005

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The Importance of Preconception Care in the Continuum of Women's Health Care

Committee Opinion Number 313, September 2005

(Reaffirmed 2015)

ABSTRACT The goal of preconception care is to reduce the risk of adverse health effects for the woman fetus or neonate by optimizing the womans health and knowledge before planning and conceiving a pregnancy Because reproductive capacity spans almost four decades for most women optimizing womens h...

September 2005

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Nonmedical use of Obstetric Ultrasonography

Committee Opinion Number 297, August 2004

(Reaffirmed 2015)

ABSTRACT The American College of Obstetricians and Gynecologists ACOG has endorsed the Prudent Use statement from the American Institute of Ultrasound in Medicine AIUM discouraging the use of obstetric ultrasonography for nonmedical purposes eg solely to create keepsake photographs or videos The A...

August 2004

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Pain Relief During Labor

Committee Opinion Number 295, July 2004

(Replaces No. 231, February 2000, Reaffirmed 2015)

ABSTRACT Pain management should be provided whenever medically indicated The American Society of Anesthesiologists ASA and the American College of Obstetricians and Gynecologists ACOG believe that women requesting epidural analgesia during labor should not be deprived of this service based on thei...

July 2004

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