ABSTRACT
The fundamental trust between doctor and patient is betrayed when pregnant patients experience mistreatment during childbirth. Fiduciary law provides a valuable lens for examining obstetric violence because fiduciary principles help reveal how certain conduct violates a patient’s trust, leading to physical, emotional, and psychological harms. Although physicians were not among the original fiduciaries, courts have recognised that fiduciary principles are at the heart of the doctor-patient relationship. Fiduciary law prioritises loyalty and the protection of the vulnerable party from abuse of power by the fiduciary who has been entrusted to act in the beneficiary’s best interests. The law’s concern with the transfer of power to a party with greater expertise, the risk that conflicts of interest might influence the exercise of that power, and the resulting vulnerability on the part of the transferring party make fiduciary law a useful framework for examining the dynamics that enable and tolerate obstetric violence. By examining mistreatment during childbirth through a fiduciary lens, it becomes clear that certain common maternity care practices depart from the values that characterise the doctor-patient relationship and therefore should constitute a breach of fiduciary duty. This chapter applies fiduciary principles to conduct that constitutes obstetric violence in order to analyse the potential for fiduciary law to redress provider mistreatment during childbirth.
