Blame and Accountability (written originally september 2006)

Blame and Accountability.

Are they polar opposites? Or do they swing an intricate dance around each other? Can you only have one and not the other? Does one negate the other? If you use blame, then are you not accountable? Or can you be accountable and still have blame?

This random thought pattern occurred to me as I tried to sleep last nights, a fall cold wracking my body with coughs that have sent my muscles into spasms.

The context that I was thinking was a comment that “Women should be accountable for their cesareans, not blaming Dr’s, nurses, etc. That women have walked out, etc..” And it angered me.

And then I thought about this… Can there not be blame and accountability at the same time? And also I think this is a harsh line to walk.. It was not too long ago that a woman was held accountable for being raped… That blaming the attacker was wrong…

And then I thought about the similarities between rape and coerced surgery.
Both “attackers” have blinders on, both are looking out for themselves and what they want, irrelevant of the other party. An attacker wants sexual gratification, domination. A coerced cesarean provider wants control, limit of their liability. Both of these two individuals act on motives that are swayed to their desires, ignoring the desires of the victim.

A woman who was coerced into a cesarean is told lots of postmortem comments. Like “you could have found another OB”, “you could have walked in pushing”, “you could have refused” etc…”you were weak, you were ignorant”

A woman who was raped was told “you were asking for it, in your dress and behavior”, “what do you expect you were in the wrong place, wrong friends, etc”. “you could have fought harder, why didn’t you?” “your actions made you weak, vulnerable, a target”. “you should have known better than to be there, or with them”

So does this take the blame off of the attacker? The OB? Both who were the dominant party in the situation? And on this note, yes, in society it is noted that “men have more control, more power, more respect” “Dr’s are more intelligent, have the answers, are altruistic, {do no harm}, have your best interest in mind”. Can we say that this is 100% correct? No, there are exemptions. Are all men rapists? (and a woman can also be a rapist), Are all OB’s self centered, uncaring, control freaks?

Does the victim already blame themselves? Hold themselves painfully accountable for the events of that day? The time leading up to it? I think you will be hard pressed to find one that does not have guilt, remorse, over the decisions made.

So that leads me to this? Can you wrap blame and accountability up into responsibility? Who was responsible for those events that occurred? Obviously BOTH parties. Rape takes two, and well surgery takes many…

Is it wrong then to lay blame on others? OB’s, husbands, family, friends, strangers? Does by saying you blame them mean you are not accountable? Or can it be a mix of both? Were they not a factor, did they not contribute to the end result?

Can the victim then not express anger, hostility towards the other participant? Is that wrong? Are they to ignore that, to not blame anyone else and take the burden of responsibility solely onto themselves? To allow the other party to not be responsible for their actions?

Yet that is what we have done. We have legalized the coherced cesarean and placed the blame on ourselves, ignorant weak women. That it is ok in society for the all knowing, in control OB to “have done everything in his power that he could do”, irrelevant to the woman’s desires.

People always say you have options, choices.. But is this true? Is life like the endless possibilities of multiple outcomes? Are there not physical restraints placed upon us? Here are some examples… When people state… well you could have….

Find another OB… Alright, let’s look at this.. Is there an unlimited supply of OB’s to choose from in all areas? Can you just pick up the phone and talk directly to an OB? Ask them the questions to rule out their intentions? Finances are a question.. Not all OB’s may be covered by insurance.. So then should you go into debt, loose money (that maybe you physically just do not even have?)to find one? Drive endless miles to another area?

Have a home birth (or possibly unassisted) birth.. Let’s face it, for all this is NOT a wise idea for everyone. Yes it is an option, yes it can turn out well. And honestly I have nothing against this personally (and I am planning one in the future for myself), but there are some risks that make this an expensive gamble. OB’s and hospitals to exist for a reason. For example, If a woman may have a blood clotting (bleeding) disorder. This can make a home birth much more risky. So is this person not limited in their choices? Can we look at this woman and say “nahhh, the risk is not there, or it is soooo minimal”. Some may be ok with that, some may agree. Others may be afraid. Others may look for guidance and assistance. Does this make them fair game then for an unnecessary cesarean and then all the blame accountability crap aftwerwards? But we expect this woman with a limitation to be stronger, to face adversary, to take the gamble.

So this then leads me to conclude, time, location, finances, culture, family, physical health, etc are all real restraints placed upon us. Are some people in a better position to have less restraints upon them? Yes! While others have more restraints. Yet we paint the broad brush of “well you could have”. Could they?!? Is it right to say to everyone they could have?

So if the person holds a gun to the woman’s head, and threatens her, and no one is there to defend her. Should she have done a judo chop, kicked the gun away and ran? Is there not debilitating fear playing a role? what if she was physically incapable of overpowering her attacker? What is the difference between a physical gun and perceived threat, a ‘dead baby card’. So do we say to the woman who submitted to the gun, “well, you were weak”. Yet we say to a person who had the dead baby card shoved in their face multiple times “you should have been stronger, known better, whipped out all the statistics and medical facts”. That is just about as realistic as saying to the woman she should have pulled out HER gun on the attacker. Yes, some may carry a gun, and yes, some may be able to battle wits with an OB, but do we expect this of all? Yes unfortunately we do.

Let’s face it, this is what we are demanding of ourselves. To overpower all opposition, to steamroll through medicine, family, finances, miles… Some of us may be able to do this… and some not…

Ok, I am done having deep thoughts now… I hope you had a chance to look and think about these ponderings, and maybe looked and pondered on your own.