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Committee Opinion Number 664, June 2016

(Replaces Committee Opinion Number 321, November 2005)

ABSTRACT: One of the most challenging scenarios in obstetric care occurs when a pregnant patient refuses recommended medical treatment that aims to support her well-being, her fetus’s well-being, or both. In such circumstances, the obstetrician–gynecologist’s ethical obligation to safeguard the pregnant woman’s autonomy may conflict with the ethical desire to optimize the health of the fetus. Forced compliance—the alternative to respecting a patient’s refusal of treatment—raises profoundly important issues about patient rights, respect for autonomy, violations of bodily integrity, power diffe...


Committee Opinion Number 665, June 2016

(Reaffirmed 2018)

ABSTRACT: Considerable uncertainty exists about what constitutes appropriate levels of protection for adolescents as research participants and about the need for parental permission. The ethical principles that govern research include respect for individuals, beneficence, and justice, as articulated in the Belmont Report. Researchers should be familiar with and adhere to current federal regulations 45 C.F.R. § 46, and federal and state laws that affect research with minors. Investigators should understand the importance of caregiver permission—and ethically appropriate situations in which to ...


3.
January 2015

Committee Opinion Number 617, January 2015

(Replaces Committee Opinion Number 403, April 2008) (Reaffirmed 2018)

ABSTRACT: Obstetrician–gynecologists care for women throughout their lifespans and are in an ideal position to have ongoing discussions with healthy patients about their values and wishes regarding future care and to encourage them to complete an advance directive for health care. In addition, situations may arise in which obstetrician–gynecologists need to participate in end-of-life care. When end-of-life decisions need to be made while a woman is pregnant, the level of ethical complexity often is increased. The purpose of this Committee Opinion is to discuss ethical issues related to end-of...


(Reaffirmed July 2016)

The American College of Obstetricians and Gynecologists and the American Congress of Obstetricians and Gynecologists find the targeting of women of all ages by the tobacco industry unconscionable and strongly oppose the practice.


Committee Opinion Number 390, December 2007

Reaffirmed 2019

ABSTRACT: Physicians vary widely in their familiarity with ethical theories and methods and their sensitivity toward ethical issues. It is important for physicians to improve their skills in addressing ethical questions. Obstetrician–gynecologists who are familiar with the concepts of medical ethics will be better able to approach complex ethical situations in a clear and structured way. By considering the ethical frameworks involving principles, virtues, care and feminist perspectives, concern for community, and case precedents, they can enhance their ability to make ethically justifiable cl...


Committee Opinion Number 646, November 2015

(Replaces Committee Opinion No. 307, December 2004
and Committee Opinion No. 377, September 2007)
(Reaffirmed 2018)

ABSTRACT: Inclusion of women in research studies is necessary for valid inferences about health and disease in women. The generalization of results from trials conducted in men may yield erroneous conclusions that fail to account for the biologic differences between men and women. Although significant changes in research design and practice have led to an increase in the proportion of women included in research trials, knowledge gaps remain because of a continued lack of inclusion of women, especially those who are pregnant, in premarketing research trials. This document provides a historical...


Committee Opinion Number 633, June 2015

(Replaces Committee Opinion Number 422, December 2008) (Reaffirmed 2018)

ABSTRACT: Alcohol abuse and other substance use disorders are major, often underdiagnosed health problems for women, regardless of age, race, ethnicity, and socioeconomic status, and have resulting high costs for individuals and society. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines substance use disorder as a pathologic pattern of behaviors related to the use of any of 10 separate classes of substances, including alcohol and licit and illicit substances. In order to optimize care of patients with substance use disorder, obstetrician–gynecologists are encou...


Committee Opinion Number 385, November 2007

Reaffirmed 2019

ABSTRACT: Health care providers occasionally may find that providing indicated, even standard, care would present for them a personal moral problem—a conflict of conscience—particularly in the field of reproductive medicine. Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a patient's health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities. Conscientious refusals that conflict with patient well-being should be a...


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 patient's best interests, and mutual consultation. In addition to establishing a diagnosis, testing provides opportunities to educate, inform, and advise. The ethical principles of respect for autonomy (patient choice) and beneficence (concern for the patient's best interests) should guide the testing, counseling, and reporting process. Clear and ample communication fosters trust, facilitates access to services, and improves the quality of medical care.


Committee Opinion Number 501, August 2011

(Reaffirmed 2017)

ABSTRACT: The past two decades have yielded profound advances in the fields of prenatal diagnosis and fetal intervention. Although fetal interventions are driven by a beneficence-based motivation to improve fetal and neonatal outcomes, advancement in fetal therapies raises ethical issues surrounding maternal autonomy and decision making, concepts of innovation versus research, and organizational aspects within institutions in the development of fetal care centers. To safeguard the interests of both the pregnant woman and the fetus, the American College of Obstetricians and Gynecologists and t...


Committee Opinion Number 456, March 2010

(Reaffirmed 2017)

ABSTRACT: In this Committee Opinion, the Committee on Ethics of the American College of Obstetricians and Gynecologists endorses the College's ongoing efforts to promote a just health care system, explores justifications that inform just health care, and identifies professional responsibilities to guide the College and its members in advancing the cause of health care reform.


Statement of Policy (Approved by the Executive Board July 2012), July 2012

Acknowledging the significant interplay of women's human rights with the overall health of women and society, the American College of Obstetricians and Gynecologists and the American Congress of Obstetricians and Gynecologists (ACOG) ardently support efforts to improve the dignity, autonomy, rights and health of women in the United States and globally.


13.
November 2014

Statement of Policy (Revised and approved November 2014), November 2014

The following statement is the American College of Obstetricians and Gynecologists’ (ACOG) general policy related to abortion. The College’s clinical guidelines related to abortion and additional information are contained in the relevant Practice Bulletins, Committee Opinions, and other College documents.


Statement of Policy (Reaffirmed July 2014), July 2014

The problem of perinatal transmission of HIV infection was first appreciated in 1982. In 1991, the Institute of Medicine (IOM) recommended a policy of routine counseling and offering testing (with specific informed consent) for HIV infection to all pregnant women. Since 1991, there have been major advances in the treatment of HIV infection, including demonstration in 1994 of the efficacy of zidovudine to reduce perinatal transmission. The U.S. Public Health Service subsequently issued guidelines for use of zidovudine to reduce perinatal transmission and for counseling and voluntary testing fo...


Statement of Policy 091, May 2015

Advocacy on behalf of women’s health is central to our mission. The United States Congress and Statehouses are increasingly affecting the practice of medicine, our specialty’s ability to care for our patients, and the future of women’s health. The American Congress of Obstetricians and Gynecologists supports member involvement in legislative and political advocacy to help ensure that lawmakers and government entities make informed decisions on issues related to women’s health.


(Reaffirmed July 2014)

The American College of Obstetricians and Gynecologists (the College) and the American College of Nurse-Midwives (ACNM) affirm our shared goal of safe women's health care in the United States through the promotion of evidence-based models provided by obstetrician–gynecologists (ob-gyns), certified nurse-midwives (CNMs), and certified midwives (CMs). The College and ACNM believe health care is most effective when it occurs in a system that facilitates communication across care settings and among providers. Ob-gyns and CNMs/CMs are experts in their respective fields of practice and are educated...


The health and economic benefits of paid parental leave are well documented. The American College of Obstetricians and Gynecologists (ACOG) endorses paid parental leave as essential. Paid parental leave includes maintenance of full benefits and 100% of pay for at least six weeks. Those who choose to have children should not face discrimination, and discrimination on the basis of pregnancy is explicitly prohibited. (1, 2) Workers who choose to have children make an equal commitment to the workplace and training environment as those who do not. Workers eligible for paid parental leave include ...


Approved by the Executive Board May 2013; Revised and reaffirmed

Government serves a valuable role in the protection of public health and safety and the provision of essential health services. The American College of Obstetricians and Gynecologists (the College) and the American Congress of Obstetricians and Gynecologists (ACOG) support this proper role of government. Laws that veer from these functions and unduly interfere with patient-physician relationships are not appropriate. Absent a substantial public.


Statement of Policy (Amended and Reaffirmed July 2014), July 2014

The American College of Obstetricians and Gynecologists (the College) is the representative organization of physicians who are qualified specialists in providing health services to women. The College is committed to facilitating access to women’s health care that is both safe and high quality. One method of attaining this goal is to assure that providers of care meet educational and professional standards of a certification process. The College recognizes the educational and professional standards currently used by the American Midwifery Certification Board (AMCB) to evaluate and certify midw...


(Approved by the Executive Board February 2008, Revised and Approved July 2012)

Resident training in obstetrics and gynecology incorporates the full spectrum of obstetric and gynecologic practice as defined in the special requirements promulgated by the Accreditation Council for Graduate Medical Education (ACGME). These include diagnostic, therapeutic and operative procedures used in the practice of the specialty. The certification process of the American Board of Obstetrics and Gynecology Inc. (ABOG) evaluates medical knowledge and patient care skills of individual practitioners in the broad range of obstetrics, gynecology and women’s health care. The Maintenance of Cer...


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