“Electronic Fetal Monitoring, Cerebral Palsy, and Medical Ethics”

A Consultant Neurologist in private practice, Dr. James C Johnston holds an MD from the University of Texas Health Science Center, is a Diplomate of the American Board of Psychiatry and Neurology, and an Attorney and Counselor at Law. Dr. James C Johnston is also an accomplished clinical researcher and medical author.

Among Dr. James C Johnston’s numerous peer-reviewed articles on cerebral palsy and electronic fetal monitoring, he published “Electronic Fetal Monitoring, Cerebral Palsy, and Medical Ethics: Nonsense of a High Order” with coauthors Berna Arda and Thomas P Sartwelle. This article appeared on May 2, 1017 in the medical law, health governance, and bioethics journal Medical Law International.

Electronic fetal monitoring (EFM) is employed to monitor the heart activity of unborn babies during the labor process. The inventors of EFM saw great benefits for the prevention of cerebral palsy (CP), believing that the technology could predict CP and allow physicians the time to prevent CP by ordering immediate C-sections.

“Electronic Fetal Monitoring, Cerebral Palsy, and Medical Ethics” demonstrates that EFM has done nothing to combat CP since the technology became the standard of care almost half a century ago. Furthermore, the article describes how EFM harms mothers and babies alike and discusses how physicians relying on EFM violate the fundamental bioethical principles of autonomy, beneficence, and nonmaleficence.

James C. Johnston, MD, JD and his colleagues have also published an article in the 2018 Surgery Journal highlighting the failed arguments of a typical EFM advocate. This article, “Continuous Electronic Fetal Monitoring During Labor: A Critique and Reply to Contemporary Proponents” is freely available in the open access journal or through the following link on Researchgate.net:

https://www.researchgate.net/publication/323614188_Continuous_Electronic_Fetal_Monitoring_during_Labor_A_Critique_and_a_Reply_to_Contemporary_Proponents

The Medical Law International article is also open access and available through Researchgate.net under Dr. James C. Johnston: https://www.researchgate.net/publication/316693326_Electronic_fetal_monitoring_cerebral_palsy_medical_ethics_Nonsense_of_a_high_order.

GLOBAL NEUROLOGY REPORT: THE PERILS OF FETAL MONITORING IN AFRICA

Dr. James C Johnston

Maclean’s news recently interviewed neurologist and attorney Dr. James C. Johnston, his Ethiopian colleague and neurology Professor Dr. Mehila Zebenigus and Rwandan neurologist Dr. Jules Nshimiyimana for an editorial discussing the perils of using electronic fetal monitoring (EFM) in Africa.

Western medical advances exported to developing nations are supposed to improve healthcare and save lives.  However, “The West sometimes exports not just its medical advances, but its medical mistakes.”  This is unquestionably the case with EFM, a procedure that causes more harm than good.

EFM has been a birth myth for fifty years.  It is the standard of care in the West despite overwhelming evidence that it is ineffectual, rife with interpretive errors, has a 99% false positive rate, and has completely failed to reduce the incidence of cerebral palsy or any other neonatal neurological disorder.  EFM has, however, dramatically increased the caesarean section rate.  And C-sections create needless dangers to mothers and babies, increase risks in future pregnancies, and may account for an increased risk of future chronic diseases and neuropsychiatric disorders in children.

Why is this sham procedure being used against all scientific evidence?  To protect physicians and hospitals from lawsuits, as well as generate significant revenue.  And doing the procedure is not only medically harmful, but it completely neglects patient autonomy and informed consent.

Drs. Zebenigus and Johnston, along with renown medical ethicist Professor Berna Arda and leading medical malpractice attorney Thomas P. Sartwelle have discussed these concerns in the peer reviewed literature with publications in the Journal of Child Neurology, British Medical Journal, Journal of Maternal Fetal and Neonatal Medicine, Journal of Childhood and Developmental Disorders, Surgery Journal, Medical Law International, Neurologic Clinics and several other publications including the Legal Medicine and Medical Ethics textbook of the American College of Legal Medicine.  Many of these articles are freely available at ResearchGate.net:  https://www.researchgate.net/profile/James_Johnston6.

The more serious problem is that EFM is now being pushed in Africa, where the potential damage from a useless procedure is compounded by the utter waste of very limited resources.  The global fetal monitoring market is a multi-billion dollar business, and most of the growth in the next decade is projected to be in developing regions such as sub-Saharan Africa.  Drs. Zebenigus and Johnston have already seen the use of EFM machines increasing in Ethiopia, and Dr. Jules and other physicians report the same in Kenya, Rwanda, Tanzania, Uganda and other countries.

The cost of the EFM machines, training staff to read a useless test, and the resulting unnecessary C-sections all drain valuable resources that would be better used to care for children who have cerebral palsy.

“EFM has made birth less safe in the United States – and now, through a kind of medical imperialism, it is poised to potentially make birth less safe throughout the world.”

Read the Maclean’s news article at:

https://www.macleans.ca/society/health/the-use-of-electronic-fetal-monitoring-is-expanding-into-africa-and-thats-a-problem/