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10 Responses to Pressure to Consent

admin September 20, 2012

Sometimes, if you’ve done your research and chosen not to go for a particular test or procedure, your health professional doesn’t take the news very well.  Some professionals may try scare tactics like “Your baby will die” or “I’ll drop you as a patient” in order to get you to comply.

Rather than getting angry and frustrated, or worse, giving into pressure, try these 10 responses to a doctor who won’t take “no” for an answer:

1. “I don’t consent to that.”

Basic response.  Rather than arguing or trying to prove you know what you’re talking about, just say this.  Repeat as needed.  This is especially helpful in a hospital setting, when they *can’t* drop you or make you leave and want to push something unnecessary on you right now.

2. “I’ll get back to you on that.”

This gives them a little hope that maybe you’ll change your mind, even if you won’t.  You can always begin looking for other care (if you feel that refusing would cause a serious issue and/or you would be dropped for refusing) or call them later or go back when you have your husband or best friend or another “reinforcement.”  This just saves an argument, although it doesn’t permanently end the situation.

3. “I understand it’s procedure, but based on this research, we feel this is the right choice for us.”

Print a couple of basic documents and bring them to your appointment if you know that refusing a particular test or procedure is going to be controversial, and let them know that this is why you are refusing.  Some doctors may actually have not run across the information and may be interested to learn (even those who try hard to keep up simply can’t read everything!).  Others, well, still won’t listen.  But at least you feel confident because you have the reasons why you are making the decision in front of you.

4. “If the situation changes, we can discuss it again.”

No one is suggesting that you refuse tests or procedures that are medically necessary.  It may reassure your doctor to know that if s/he feels that, given your individual situation, it was necessary, you would do the test/procedure.  Hopefully this will keep the lines of dialogue open so that you receive the care you really need — and not just what’s “standard.”

5. “Thanks for the information and your educated opinion, but we will be making that decision.”

This recognizes that the doctor has provided valuable information, but that you are in charge of your body and your care.  This can be coupled with “we’ll get back to you” if you feel uncomfortable saying no without your support person present.

10 responses to pressure to consent pinterest

6. “I have made my decision, and I don’t want to discuss it further at this time.”

This is a strong statement, for doctors who will not back off, even after you have tried other tactics.  If you say this, then you have to stick by it.  You may need to change the subject or leave the room.  Stay with it, though.  You don’t have to do anything you don’t want to.

7. “What are the alternatives to this procedure?”

Change tactics.  Rather than arguing about the ‘recommended’ test or procedure, start asking about alternatives.  You might ask follow up questions that are appropriate.  For example, if you’re refusing the gestational diabetes test, you might say, “Could I check my blood sugar at home for a couple of days after meals?  Could we stick with the urine tests and follow up only if we see glucose in my urine in concerning amounts?”  You may also ask for the risks and benefits of these alternatives (which doctors ideally would provide you with anyway, but many don’t).

8. “This is against my personal/religious beliefs.”

Some people have strong moral or religious beliefs that prevent them from submitting to certain tests or procedures.  For some women, it is literally against their religions.  For others, they have a strong belief in the body carrying and birthing babies naturally, and tests or procedures that are not medically necessary interfere with these beliefs.  Many doctors do not want to argue with beliefs, so this may be a route to take for some.

9. “I’m sorry, but I’m not going to do it.”

Be very clear.  This is a final statement and might also be followed up with “I do not consent,” depending on the situation.  It’s what you say when none of the above statements have helped.  Your doctor isn’t willing to let you have time to decide, or come back to the discussion if and when there is a medical reason, and is not interested in your personal beliefs.  His/her mind is made up that you need this test or procedure, no matter what, right now.  This might make the doctor angry and you might get ‘fired’ from the practice.  Stick to your guns and see the final point.

10. “We will be seeking care elsewhere.  Thanks for your time.”

If you simply cannot see eye-to-eye, find someone else.  There are other doctors and midwives out there and you may be better off with a different care model.  Who wants to spend her entire pregnancy and birth fighting anyway?  Even if you are fairly late in your pregnancy, you can still switch.  Even if you’re in labor, you can still kick any doctor or nurse you don’t want out of your room and ask for a new one — it’s your right as a patient.

Remember, it is your body and your baby.  You do not have to consent to procedures or tests that are not medically necessary or which make you uncomfortable.  If you want all the screening tests, go for it!  But if you don’t, and are not high risk of whatever (or don’t care to know, where applicable), you should not be forced into it.  Say what you need to say and take a support person along if you want.  Stand up for yourself!  It’s worth it.

Have you ever had trouble refusing to consent? What did you say or do?

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22 Comments

  1. During my pregnancy I had a doctor tell me that I needed growth scans every 4 wks because I had gestational diabetes — which is complete hooey. He then told me that if I didn’t my baby could die. I said a growth scan is not going to prevent that, walked out and never returned. I went on to have a very healthy 9 lb 2 oz baby at full term at home.

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  2. And this is why I love your blog… 🙂

    Thank you! It might be wise for expectant moms to print out this list and keep it with them. Sometimes the pressure from a physician can make it extremely difficult to collect ones thoughts and give a satisfactory answer on the spot. The number one most important thing is to make sure you never walk into the wellness care alone. Always bring your significant other, close friend, or your doula so you can’t be cornered. It’s worth taking time off of work or whatever else is necessary to protect your growing child and your own body.

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  3. I think these are very strong guidelines for dealing with any medical procedure and/or medical professional. In hindsight, I probably should have used some of these in my former medical care.

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  4. I would say that if you need to use these responses then it’s time to find a new health care provider! I never had to refuse consent because my midwife was so wonderful and we were always on the same page. After having been through a natural birth and talking to many other women, I can assure you that you will not want to be negotiating or fighting your way through. Most women really need to go within themselves and focus without talking.

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  5. I am going through this presently! My doctor has been pressuring, coercing, and manipulating me for weeks now to have an unecessary C Section simply because she doesn’t want the “liability” of a VBAC. I am now 5 days beyond my expected due date and she is pulling out all the stops, telling me the baby could “easily die” and how could I make this choice? She hand wrote a note saying I was aware my baby could die if I chose NOT to go with an elective repeat cesarean and was going against doctor’s recommendations. I know I didn’t HAVE to sign it but I did just to shut her up, it was about to get ugly. Her partner, whom I saw after she left to go do another surgery, advised the same, and even called the social worker at the hospital to contact me with more manipulation. Today I just didn’t answer their calls! How dare they pressure women with what they “think” is best with no scientific backing other than the fear of litigation and legal reasoning? SICK OF IT.

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  6. All I had to say with regards to the blood glucose test, the prenatal rhogam shot, and their if-you’re-one-week-late-you-will-be-induced policy was: we are choosing to decline that test/procedure. I didn’t have any other trouble, but I did choose my doctor very carefully. They knew our expectations from the get-go and I think that has helped a lot. I say if they make you feel uncomfortable drop them and find someone who respects your wishes.

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  7. What a great post! Good suggestions. I had similar experiences with various providers throughout my pregnancy ) and ended up switching care at the very, very end to avoid an induction ). (Sorry for all the links–easier than rewriting all of it.) I especially recommend taking someone else with you and always, always deferring a decision until later if you are feeling pressured. You do have the right to a provider who is fully supportive of your decisions, in that they are safe and informed. The best scenario is a woman and provider who can work together to determine what’s safest and best for mom and baby, with clear and respectful communication. If you’re not getting that, switch. It’s never too late. And it’s worth it. Your body, your baby, your birth.

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  8. Great responses. Also a good list to keep on hand for pediatrician visits with your new baby!

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  9. […] 10 Responses to Pressure to Consent […]

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  10. Good list, I agree if you have to get to the firmer statements: find a new care provider.

    Marcie-you really should contact an attorney. This type of “care” needs to stop. This falls far outside the guidelines of ethical medical practice. I assume by now you are snuggling your sweet baby, and pray that all is well.

    I can connect you with an attorney who wants to help end this type of manipulation, it so often results in violation of human rights.

    We need to stand up and say, enough!

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  11. Ladies, get yourself to a midwife and fast. I am a mother of four. I have had two hospital births and two water births with lovely midwives. I would choose a midwife over a doctor any day. You’ll never have this problem with a midwife. They respect your wishes, your body and your baby.

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  12. […] article addressing 10 Responses to Pressure to Consent (remember, it isn’t “informed consent” if you do not have the option of saying […]

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  13. “How dare they pressure women with what they “think” is best with no scientific backing other than the fear of litigation and legal reasoning? SICK OF IT.”

    With it’s immense power-wielding hand, the medical industry drives health & medical care where it wants.
    With Obama’care’ coming now into our lives, what degree of self-autonomy and parental authority are we thinking we possess? Richard N. Fogoros: ” The right to use your own resources to protect your own well-being, of course, is essential and fundamental to the American idea. Once the Progressives successfully establish the principle that, in the name of universal fairness, you may not do so, the whole concept of individual freedom evaporates, and with it, the Great American Experiment.” Are we wards of the State yet?

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  14. I run into this problem ALL THE TIME, and not just with pregnancy visits. I’ve been asked to take off my clothes by male doctors so many times when the area they were examining had nothing to do with say… my breasts for example; that now I only see female doctors. It seems to me that too many of the men will say anything to try to get me undressed.

    And yes, without coming across as being too conceited, I’ve been told by many people that I’m very attractive, for whatever it’s worth.

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  15. These are all very good comment.
    However, you could not imagine how difficult would it be to switch doctors in late stage. My wife is in 38th week (we live in NYC), and we are trying to switch doctors because of how our doctor behaved/ commented in recent weekly exam (unimaginable crazy comments/ suggestions). Spoke to 3 alternate doctors already, and so far every one refused to take late transfer.
    So what that I can “fire” my old doctor if no other doctor in NYC wants to take me on.
    These top 10 responses will come in very handy.
    Thank you

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  16. […] 10 different responses when you feel pressured to consent to something that feels wrong. I have always reminded my clients “polite but firm” and most of these can fit that criteria, if delivered in the right tone of voice. […]

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  17. Not all midwives are “GOD/DESS” sent! I’ve had more issues with explaining to them a regular 2hr post meal at home testing of blood glucose that avrages between 80 – 130 is not death to my child, when it rarely hits a 150-170 (like once in first two weeks of learning to eat less carbs) it was more of my body saying “don’t stress me out like that!” not “you ate what & didn’t hit a tredmill!?” They also would not take into consideration my fasting test was done when I normally sleep, was unable to do anything other than sit in a waiting area (I like to pace, walk, & be able to move-not be a trapped rat), or anything else that factors into that pactulair tests results. There were no keytones present, or glucose in urin. Plus, they refused to run an A1C to see I was right that the Fasting Glucose results could be asqued! It took nearly 3m & a smart nurse to agree that an A1C would be a good idea, came back 4.9 (normal is 4-6, higher maybe sign of dibetic issues & lower a sign of glycemic). It’s funny how having two kids in two different states prior, living over 3 decades, & having grown up with not just medical professionals in the family but those that have conquered many “not-cureable” illness make me stupid, perhaps it’s just wanting my body to heal itself, not some poisen the drug companies taught doctors is the only way for them to keep making money, after all a healthy patient with no side effect symptoms taking a plant they can raise at home makes no one money, & the drug companies can’t patent a plant! Natural herbs, spices, & molds took good care of many our families for 100’s of years, most good older meds are still based from this, but why take something with thousands of side effects when some cinnimon bark, garlic, gensing, or even just more sunlight & freash air exercising will reverse most if not all of what’s wrong-best of all, even in heavy smog communities the fresh air is better for you than the meds they sometimes try to force into you. I only conceed when the drug companies medical procuder is less harmful than what they’re trying to prevent, IE: asthmatic has an attack, a nubulizer treatment of xopenex is recommended, than by all means save their life; man grabs left arm going into a heart attack, off the job EMT worker is beside him & gives a baby BEAR asprine, by the time the man gets to the hospital he’s fine again, the EMT worker just saved his life before an ambulance or doctor could arrive! Not something that’s need everyday/week/year, but no quick life saving alternitive was available either. Now the asthmatic needs to avoid triggers, take more steam baths, use a humidifier, if over age 2 dring local raised-farm fresh honey & lemon water or tea (1t honey with local bee pollen still in it, not local store brand plus lemon juice & 6-8oz water or lemon zest [rind] boiled in water) & follow-up with anything else they know helps, oranges & limes or grapefruit works if lemon is an allergy/dislike but not as well. Same goes for heart attack man, avoid triggers, maybe change eating habits or weight level (sometimes too thin is more deadly than too heavy, watch the BMI on land vs in water ratio), stop using tar added tobacco products-if you have to smoke or chew get leaves from a farmer or raise your own, look into the few products that add nothing like American Spirt, but know it might be better to quit all together; eliminate as much stress as possible; reduce or quit alcohol, it retard your bodies response system & slows your metoblism plus adds empty calories, now it does thin you blood so you won’t clot easily which is good so you won’t risk attack again as easily, but you’re still killing brain cells if drinking more than 2 shots/24oz beer per day total! …bottom line, both cases could have prevented issues if know about prior, & easily can prevent further problems 100% naturally!

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  18. I had to have a tough conversation with my OB last week. At 35 weeks, she was suggesting that we induce, just to make sure I don’t have a breech birth. (What?!?) No WAY! She really pressed the matter, and I just simply had to tell her no. Since my husband wasn’t even in town, it wasn’t even an option. She kept telling me that it would be the safest option, and I wouldn’t want to risk another breech birth where the baby could potentially die. (This is my 6th baby. All of my babies have been late. Not gonna induce 5 weeks early. No plans to induce at all.) She’s been giving me a hard time, because I’m doing dual care with intentions of another homebirth.

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I’m Kate, mama to 5 and wife to Ben.  I love meeting new people and hearing their stories.  I’m also a big fan of “fancy” drinks (anything but plain water counts as ‘fancy’ in my world!) and I can’t stop myself from DIY-ing everything.  I sure hope you’ll stick around so I can get to know you better!

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