OG35.{7,9-10,14} | Communication, Ethics, Consent and Universal Precautions — Summary & Reflection

KEY TAKEAWAYS

Professional skill in obstetrics and gynaecology encompasses four inter-dependent competencies. Communication requires a structured, empathic approach to discussions of illness, bad news, and outcomes; the SPIKES protocol provides a reproducible framework for difficult conversations in OG. Ethical behaviour rests on the four principles of autonomy, beneficence, non-maleficence, and justice, with specific OG applications in reproductive autonomy, PCPNDT compliance, and confidentiality in HIV-positive pregnancies. Informed consent is a five-step process — capacity, disclosure, understanding, voluntariness, decision — with special-situation modifications for minors (guardian consent + patient assent), unconscious patients (proxy or emergency exception), sterilisation (woman's independent consent), and MTP (RMP certification). Universal precautions require hand hygiene at five moments, PPE selection based on exposure risk, correct donning and doffing sequence, safe sharps handling, and needle-stick management following the immediate wound care → report within 1 hour → PEP within 72 hours (ideally 2 hours) → hepatitis B HBIG within 24 hours (if non-immune) framework per NACO 2014 guidelines. Each skill is built through supervised practice in the OG ward and clinical skills laboratory.

REFLECT

Recall a clinical encounter you observed or participated in during your OG posting where communication, ethics, consent, or infection prevention was handled particularly well — or particularly poorly. What was the clinician doing that made it effective, or what was the omission that made it fall short? Use the frameworks from this module to analyse that encounter specifically. Professional skill in these four domains is not innate — it is practised, reflected upon, and refined encounter by encounter.