ABSTRACT
It is good medical practice to involve all patients in the decision making process for their own management and to allow them as much choice as possible in the type of treatment they are to receive. It also is quite logical in situations where alternative managements are assessed as equally or almost equally beneficial to allow the patient a free choice between them. This policy is rarely followed. Obstetricians are perhaps more prone than most to fall into the trap of being dogmatic about those issues over which there is greatest uncertainty. Thus, one consultant may inform his patients that there are very limited grounds for elective caesarean section for breech presentation at term and that it is quite safe to plan vaginal delivery; another, in a neighbouring unit, may take the opposite view and state that caesarean section is mandatory in such cases and that the potential dangers of attempted vaginal delivery are always too high for this to be a sensible option.
