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Clubfoot is a serious birth defect in which an infant’s foot is twisted inward and downward. It is usually an obvious and isolated defect for otherwise normal and healthy newborns. If untreated, then clubfoot does not spontaneously improve. As affected children develop, they may come to walk on their ankles or on the sides of their feet, creating a painful movement disability. Many different devices and techniques, including surgery, were deployed to correct clubfoot – with limited success, at best. However, an immigrant to the United States who was displaced by the Spanish Civil War changed all that. Ignacio Ponseti developed a highly effective, nonsurgical method to return the infant’s developing foot to its normal position using progressive manipulation and plaster casting. How Ponseti devised his lifechanging method is an amazing story, especially as it revived, revised, and publicized a technique originated by Hippocrates some 2,400 years ago!
The principle of autonomy recognizes that it is the voluntary decision of the patient to authorize or refuse clinical management based on adequate and complete disclosure by the physician about the patient's condition and management with the understanding of this information by the patient. If the patient refuses the ultrasound examination due to the fears of its harmful effects, the physician must clarify the facts to the patient, support her, and illuminate her fears. During obstetric ultrasound scanning and in occasional circumstances where the unborn child may suffer from a condition that needs a treatment and this treatment threatens the mother's life, there must not be any obligation upon her to tolerate this treatment. All fetal treatment necessitates accessing the fetus through the pregnant woman's body, and nonsurgical treatments have long been a part of pregnancy care. Ethics as a subdiscipline of ultrasound examination and intervention has significant clinical implications.
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