AMBestabortion.docx
- 文档编号:26879066
- 上传时间:2023-06-23
- 格式:DOCX
- 页数:19
- 大小:28.19KB
AMBestabortion.docx
《AMBestabortion.docx》由会员分享,可在线阅读,更多相关《AMBestabortion.docx(19页珍藏版)》请在冰豆网上搜索。
AMBestabortion
AbortionFacilities(Outpatient)
AbortionFacilities(Outpatient)OutpatientClinicsOutpatientDispensariesOutpatientInfirmariesPregnancyTerminationFacilities(Outpatient)OfficesandClinicsofDoctorsofMedicineHealthCareFacilities-hospitalsHealthCareFacilities-clinics,dispensariesor...
a0160
RevisionDate:
10/89
Line
Best'sHazardIndex
UnderwritingComments
AUTOMOBILELIABILITY
1
Higherifpatientsaretransported.
AUTOMOBILEPHYSICALDAMAGE
--
GENERALLIABILITY
7
Levelofemergencyplanningkey.
PRODUCTLIABILITYANDCOMPLETEDOPERATIONS
--
ENVIRONMENTALIMPAIRMENTLIABILITY
--
PROFESSIONALLIABILITY
9
Trainingofstaffcrucial.
DIRECTORS'ANDOFFICERS'LIABILITY
4
WORKERS'COMPENSATION
6
CRIME
3
FIREANDE.C.
7
Totallosseslikely.
BUSINESSINTERRUPTION
5
Communityhostile--relocationmaybedifficult.
INLANDMARINE
4
BOILERANDMACHINERY
--
Low1-3,Medium4-6,High7-9,VeryHigh10
SICCode
SICClassification
8011
OfficesandClinicsofDoctorsofMedicine
ISOCode
ISOClassification
44425
HealthCareFacilities-hospitals
44439
HealthCareFacilities-clinics,dispensariesorinfirmariestreatingoutpatientsonly-noregularbedandboardfacilities
SpecialExposures
Arson,bombing,picketingandvandalismbyanti-abortiongroups
Confidentialityofpatientrecords
Directors'andOfficers'Liabilityfornonprofitorganizations
Substandardfacilitiesorcare
RelatedClassifications
AmbulanceServicesandRescueSquads
BirthCenters
EmergencyCenters(Freestanding)
Hospitals--GeneralCare
MedicalLaboratories
SurgicalCenters(Outpatient)
RISKDESCRIPTION
a016r.
Abortionservicesmaybeobtainedthroughfull-servicehospitals,privateoutpatientabortionclinicsandthroughphysiciansinprivategynecologicalorgeneralpractice.Themajorityofdoctorsworkinginhospitalsandgeneralpracticeclinicsand/orofficesarenottrainedtoperformabortions.ClinicsalsomaybeassociatedwiththePlannedParenthoodFederationofAmerica.Thiswrite-upconcentratesonthehazardsassociatedwithoutpatientclinics.Thehazardsassociatedwithpublicandprivateclinicsareoftensimilar.Full-servicehospitalsareexcludedfromthisclassification.
Outpatientabortionclinicsarerunbyateamofphysiciansexperiencedinobstetricsandgynecologyandbyastaffofphysicians'assistants,nurses,trainedcounselorsandlaboratorytechnicians.Physicianswhoperformtheabortionsmaybeemployedpart-timebyaclinicdirectorwhilealsomaintainingprivatepracticesorhospitalstaffpositions,ortheymayownandoperateaclinicasanindividualorgrouppractice.Althoughphysiciansmustbelicensedbythestateboardofhealth,licensingofclinicsvariesfromstatetostate.Mostprivatemedicalofficesarenotsubjecttoboardofhealthlicensingorstateinspections,buttheyaresubjecttodepartmentofhealthinspections.
Outpatientclinicshavelowercoststhanfull-servicehospitalsandtrytomaintainasupportiveandconfidentialatmosphere.Mostclinicsofferpatientsavarietyofrelatedservices,suchaspre-andpost-abortioncounseling,andinformationaboutcontraceptionandfertility.Privatephysicianswhoperformpregnancyterminationservicesmaynotoffercounseling.Someclinicsmaintaina24-hourhotlineservicethatreferspatientstoanurseordoctor.Otherclinicsperformmaleandfemalesterilizationservices.Somealsoconductcommunityeducationprograms.Mosthaveacontractwithanambulanceserviceincaseofmedicalemergency.
Abortionwaslegalizednationwidein1973whentheSupremeCourtguaranteedawoman'srighttoanabortioninRoevsWade.Sincethatdecision,thenumberofabortionclinicshaveincreased,namelytosatisfythedemandforpregnancytermination.In1989,threeoutofevery10womenwillterminatetheirpregnanciesbyabortionaccordingtoPlannedParenthoodstatistics.
OnJuly3,1989,theSupremeCourtdecisioninWebstervsReproductiveServicesprovidedstateswithnewauthoritytolimitawoman'srighttoanabortion,butstoppedshortofoverturningtheRoevsWadedecision.Thenewrulingallowsstatestodecideifabortionscanbepubliclyfundedanddeterminestheconditionsunderwhichawomanisallowedtohaveanabortion(i.e.,nolaterthanthe12thweek).The1989decisionupheldarestrictiveMissouriLawthatforbidstheuseofpublicfundstopayforabortionsandbanspublichospitalsoranyothertaxpayer-supportedfacilitiesfromperformingabortionsnotnecessarytosavelife,evenifpublicfundsarenotspent.Additionally,theMissouriLawbanspublicemployees,includingdoctors,nursesandotherhealthcareproviders,fromperformingorassistinginabortionsnotnecessarytosavehumanlife,andrequiresthatmedicaltestsbeperformedonanyfetusthoughttobeatleast20weeksoldtodetermineitsviability.AsaresultoftheCourt'sdecision,manyclinicsthatpreviouslyqualifiedforpublicassistancemaynowbedenied,becauseofnewstatelegislation.
Thiscontroversialissuehassparkedmuchdebateandconfrontationfrombothabortion(pro-choice)andanti-abortion(pro-life)groups.Pro-lifegroupssuchasOperationRescueandTheNationalRighttoLifeCommitteehavefrequentlyreceiveddisorderlyconductcitationsforphysicallyblockingwomenfromenteringclinicstopreventthemfromobtainingabortions.Manypro-choicevolunteersserveasescortstoaidpeopleinenteringtheclinic.Additionally,pro-lifegroupshaveclaimedresponsibilityforintentionallysettingfiretoandvandalizingclinics.Inthepastseveralyears,extremistgroupssuchasOperationRescueandTheRighttoLifealsohavebeenheldresponsibleforbombingabortionclinics.Manyextremistgroupsadvertiseinnewspapersandthroughahotlinewhenandwheretheyaregoingtodemonstrate.Thereforeabortionclinicsareoftenabletocontactthepoliceforsecuritymeasures.
PlannedParenthoodisanonprofithealthagencythatprovidesgynecologicalexams,PapSmeartestsandbirthcontrolcounseling.In1983,PlannedParenthood's850clinicswith24,000volunteersserved3.8millionclients;its178affiliatesarethesinglelargestproviderofabortionservices.Employeesofabortionclinicshavereportedreceivingdeaththreatsandharassingphonecalls.Manytopofficialstakesecurityprecautionsfortheirownwelfare.
TheFederationofFeministWomen'sHealthCenters,basedinLosAngeleswithofficesinAtlanta,isdistributingavideotapecalled"NoGoingBack,"whichadvocatesaself-helpapproachbyteachingwomentoperformtheirownabortions.Asofthiswriting,only20clinicsintheFederationweredistributingthisvideotape,butwiderdistributionmaybepossible.Thisvideotapeisexcludedfromthiswrite-up.
MATERIALSANDEQUIPMENT
a016t.
Examiningtables,bedding,linens,operatingtablesandrecoveryfacilities;foodsupplies.
Laboratoryequipmentforpregnancytesting(throughurineorbloodtestsorultrasounddiagnosis),hemoglobinandhematocritdeterminations,Rhtyping,gonorrhealandserologicaltests,andcytologyscreening.
Surgicalequipment:
speculaandtenacula;metaldilatingrods,osmoticdilatorsorlaminariatents(tostretchthecervix);cannula,suctionmachines,curettesandforceps;syringes.
Surgicaldrugs;antisepticsolutions;localorgeneralanesthetics,narcotics;salinesolutions,prostaglandinsandoxytocins(hormones:
Rh-immuneglobulin).
Emergencyequipment:
oxygen,plasticairways,resuscitationbags,cardiacmonitorsanddefibrillators(ifgeneralanesthesiaisused),catheterneedles,intravenouslinesandfluids.
Emergencydrugs:
forcardiacarrest,seizures,asthmaticattack,allergicreactionsandnarcotictoxicity.
Officereception,bathroom,laundryand"scrub"facilities;housekeeping,cleaningandsterilizationequipmentandmaterials.
PROCESSORSERVICE
a016s.
Someclinicsterminatepregnanciesonlyuptotheendofthefirsttrimester(12weeks)andreferallpatientswhoarepasttheir12thweektootherfacilities.Themostcommonmethodofabortioniscalledvacuumaspiration(suctioncurettage).Someprivatephysiciansperformearlyabortions(uptosixweeks)intheirofficesbymenstrualextraction(endometrialaspiration).Butduetothefrequencyofcomplicationsandincreaseddiscomfortassociatedwithsuchearlyabortions,manyclinicsadvisewomentodelaytheirabortionuntilatleastthesixthweekofpregnancy.
Otherclinicsperformabortionsduringthesecondtrimester(the12thtothe24thweek);approximately10%ofallabortionsareperformedduringthistime.Second-trimesterabortionsgenerallyhaveamoderatelyhighercomplicationratebecausetheyrequiremorecomplexsurgicalprocedures.Ofthethreeprimarymethodsforsecond-trimesterabortions--salineinduction,prostaglandininductionanddilationandevacuation(D&E)--D&Eistheleasttraumaticandleastcostlyforthepatientandhasthebestsafetyrecord.Dilationandevacuationcanbeperformedundereitherlocalorgeneralanesthesia.Salineinductionprocedures--whichinducelaborupto24hoursfollowingtheinjectionofsaline--requireclosemonitoringofpatientsandgenerallyareperformedonlyinhospitals.Althoughprostaglandininductionproceduresmaynotcarrytherisksassociatedwiththesalinemethod,theymayproducesideeffectsrequiringmedication.
Mostclinicsdividetheirabortionservicesintoacomprehensivethree-stepprocess.Thefirststepconsistsofapregnancytestandcounselingconcerningthepatient'soptions.Ifthepatientchoosesabortion,shethenreceivesapre-operationmedicalexamination,includingacompletehistory,bloodpressuretest
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- AMBestabortion