THE LEGAL CATCH 22 CAUSING THE AUTISM EPIDEMIC

Dinesh Danny

Autism parent and author of "Autism Answers and Action".

The legal landscape.
Autism, being the result of legal malaise sounds like a tall order. But the concept is not really that outlandish, considering that human birth has now become a medical event involving complex interventions in most of the developed world. When any of these complex interventions is not performed correctly, it has potential to cause severe injury to the baby, the mother or both. Injuries to the baby in this case are more significant as they can have life altering consequences from brain damage. Hence there exists a long history of malpractice litigation from deliveries gone wrong resulting in badly brain damaged babies. Consequently obstetrics payouts are the among the largest malpractice payouts and rightfully so, due to enormity of the lifetime of suffering caused.
Lately however, things have quieted down significantly on the litigation front, perhaps eerily quiet, not because the problems have gone away, but because they're supressed by years of tort reform that malpractice insurance companies have silently gotten passed through state legislatures, in the years following the initial decades of patient activism in the 1980's through 90's. They have managed to cap jury payouts all under the guise of making access to medical treatment more affordable by making the medical system less litigious. But the opposite has been true. It has ended litigation at the expense of patient safety and ability to hold even the worst physicians accountable for their misdeeds.
With medical malpractice becoming so much harder to prosecute and get results, the feedback loop about dangerous drugs, bad doctors and adverse outcomes that these legal cases provided has almost ceased to exist. The pendulum has swung so far to the other side, malpractice lawyers have moved on to other greener pastures. Its easier to go after a trucking company involved in a bodily injury accident, than to go after an incompetent doctor that caused grave harm to a patient. Anything short of death of a young healthy patient has become a long shot to prove in court. However, there is no dearth of such medical malpractice. In the US for example, malpractice is the 3rd leading cause of death after heart disease and cancer. And existing birth injury lawyers have given up on risking their time and effort on new possibilities and try to focus on only the proven tracks that have been successful in the past.

Abusive labor induction
Given this backdrop, lets shift focus to the malpractice of our interest that has been totally impacted by this changed legal landscape. This is the problem of abusive induced labor that pervades the maternity wards of most western nations, which is causing the autism epidemic. The pitocin label clearly indicates it is capable of causing "Permanent CNS or brain damage" due to uterine motility. The fact that it is a result of uterine motility clearly points to traumatic brain injury from contractions. However the entire fetal monitoring apparatus is geared towards detecting hypoxia, while detection of traumatic injury is left to the discretion and interpretation of the obstetrician. The contra-indication #5 on the Pitocin label states further administration of Pitocin is contra-indicated - "Where adequate uterine activity fails to achieve satisfactory progress". This is the failure to progress diagnosis which is defined by the American College of Obstetricians & Gynecologists(ACOG) as 72 induced contractions of labor spread over 4-6 hours. Pursuing labor beyond this contraindication point causes traumatic brain damage and it is an established fact. However, obstetricians routinely cross this point of "failure to progress" diagnosis without forcing a C-section like the ACOG recommends.

Doctors protect Doctors
As much as the case for traumatic injury is based on facts established by the Pitocin labeling and the ACOG induction protocols, courts expect lawyers to interpret complex medical procedures using interpretations of expert witnesses who are doctors considered experts in their field, willing to testify that the obstetrician was wrong to allow induction to proceed for over 4-6 hours. Courts require such expert testimony to prove causation in any malpractice suit. Unfortunately most doctors who do the rounds as expert witnesses in courts, do not come forward to defend these established facts. The probable reason is because this fight is against insurance companies with deep pockets and these witnesses have mostly been compromised by taking the other side alongside malpractice insurance companies in past cases testifying against the possibility of traumatic injury. If such folks come forward to suport the case of traumatic injury they will end up perjuring themselves vs their previous cases. Herein lies the catch-22 situation that is resulting in the continuing indiscriminate abuse of Pitocin or other prostaglandin based labor induction, causing the autism epidemic, thanks to the lack of consequences to Obstetricians that continue to believe they're doing good by avoiding the C-section in these cases. And the malpractice continues to this day.

Thus the responsibility of finding a solution falls squarely in the hands of parent activism to organize a solution. That is the objective of the Autism Parents intiative, to engage in collecting evidence that would be sufficient to establish the role of abusive labor induction in causing the autism epidemic. Join this retrospective autism data collection here if you havent already.