Theatre Minutes
Kopanong Hospital,
Vereeniging, Gauteng,
South Africa
Theatre
Meeting 28 March 2003
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Project Interpretation
(Subject to correction by meeting participants)
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Mr Mbule (Medical
Superintendent):
Open meeting with background of T.O.P. e.g. septic abortions etc. Agenda T.O.P.’s
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Interpretation: The meeting is about
abortion. The Medical Superintendent opened with background on
abortions.
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15yrs old >
? T.O.P.:
Come back for Ectopic.
Lost the patient – died
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Interpretation: A 15 year old patient is
believed to have had an abortion, and returned with an ectopic pregnancy, as a
result of which she died.1
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Marie Stopes: Training in London 2/52
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Interpretation: A reference to
training in London. Marie Stopes was a birth control & eugenics advocate
who was active in the first half of the twentieth century in the United Kingdom.
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Since abortion Legal:
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^ Incomplete abortions
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Legal T.O.P. |
Interpretation: Since
abortion was legalized, there has been an increase in the number of patients
presenting with incomplete abortions. This increase must be a result of the
legalization of abortion.
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Definitions: T.O.P. > Pre-counseling
process
> Administration of tablets
(oral or vaginal Cytotec)
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Interpretation: Provision of
abortion includes the pre-counselling process, in which abortion is put
forward as a legitimate medical/moral alternative. It also includes the use of abortifacient drugs like Cytotec.
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Question: PV Bleeding is it a Surgical Emergency i.e.
Patient life threatening surgical TOP
Termination of Pregnancy (T.O.P.)
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Interpretation: Is bleeding
from the vagina a surgical emergency? In other words, does it threaten the
life of the patient, so that a surgical abortion is necessary to save her
life? Or is surgical abortion just one available treatment, so that an
abortion performed would actually be just for the termination of the
pregnancy, and not to save the life of the patient?
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Sr Charles: Breaking it down makes it a different story. |
Interpretation:
Distinguishing between these two situations leads to different moral
conclusions.
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Sr Porter (Scrub sister): Ruptured uterus and Evacuations are the
same.
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Interpretation: There is no
difference between treating a ruptured uterus and evacuating the uterus to
treat bleeding from the vagina. The result is the same.
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Mr Mbule: Try to see it as an emergency.
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Interpretation: Sister
Charles, even though it may be difficult for you, you should try to see it as
an emergency.
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Sr Smith (Area Manager):
Everybody does it, often if they don’t like it. What’s good for one – is good for everybody. No religion or moral believe is superior.
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Interpretation: Everybody does
this, and often they don't like it. If it's good for one patient
(practitioner?), it's good for everybody. All religions are the same. No one
religion or moral belief is superior to any other.
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Sr De Bruin (Chief Assistant Director):Everybody goes through emotional trauma: Personnel from T.O.P. also experiences problems.
What happens if there is an emergency and pro-life sister is suppose to be on duty and must then get a substitute?What happens? Who is responsible for death?Discrimination everybody (personnel) must have the same rules.
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Interpretation: Abortion causes
an emotional trauma for everyone. Hospital personnel also suffer from this. What
happens if there is an emergency2
and a pro-life sister is supposed to be on duty and must then get a substitute? Who is responsible for a death that occurs while she is trying to find one? To allow special
rules for pro-life personnel is
discrimination. Everyone must operate
under the same rules.
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Dr Mbule: What is stabilizing a patient? What does it mean?
When somebody is bleeding
What is your treatment? It
will not help to only put on a Line: you have to stop Bleeding : The only way is
to Evacuate.
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Interpretation: When patient
presents with vaginal bleeding and a possibly viable fetus, and a physician
says that he will not do a TOP but will stabilize the patient, what does it
mean? When someone is bleeding, what is the treatment? It will not help to
do only a transfusion. You have to stop the bleeding. The only way to do
this
is to evacuate the uterus.
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Sr Neria (Scrub sister: What is the final answer? Is everybody scrubbing
for evacuation now?
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Interpretation: What is our
decision? Is everybody going to assist with abortions?
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Sr Smith: Sr Charles will scrub for T.O.P.
evacuation.T.O.P. not to be brought under discussion again.
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Interpretation: Like it or
not, Sr. Charles will assist with abortions. This subject will not be
discussed again.
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Bosman – Area manager
Smith – Theatre in charge
De Bruin – Chief assistant manager
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