Today I saw a sickening display of medical ethics. A result of a disturbed culture. I gave a lady spinal for C section and apparently she had asked the obgyn that her family was compelete and she wanted permanent contraception. After the baby was safely delivered the obgyne

told the staff to find the patient's husband. He wasn't outside and had gone off on some errand. The patient's mother in law yelled into the OR from the corridor, "don't do it. We aren't giving you consent for it."
The patient heard inside and was irritated and told us to wait

for her husband. We stood around for a while with the uterus out waiting, but the husband didn't show up. So the obgyn told the patient that they won't do a Bilat Tubal lig because, "we don't do perm contracept without asking the husband first."
The patient thought for awhile

and said she still wanted it removed. "I told him I want it removed and that's that." the obgyn ignored her and told her it won't be done without the husband. I got very irritated and yelled at them that it is the patient's choice. It's her body and if she says so, then do it!

In the end, it wasn't done. Why? It's a difficult explanation for someone not in our culture.
1. There is no such thing as patient consent in such matters. There is no law here. The husband/family will hold person grudges and violence fueds with the doctor for making their wife

'barren' and harm the doctors, regardless of how many times you say it was the patient's choice. Safety is paramount.
2. The husband and family would ruin the woman's life and harrass her forever.

A lose lose situation. I felt very irritated at how little right a poor

village woman in Pakistan has over her OWN body. Medicine isn't all rosy and to the book in every part of the world. The biggest problem with studying a western system of medicine and coming into an eastern reality is that you'll be jarred. It is nothing like medschool.