Sarah is 31, pregnant and currently in the maternity ward of her local hospital in a rural area of the UK.  She is in the late stages of labour and the doctors present are becoming a little concerned that there may be a problem with delivery.  The doctors decide not to tell Sarah at this point, as they think the risk is rather low - one senior doctor wants to try a new method of delivery that he read in a medical journal recently, but the other two doctors haven't seen this but are willing to proceed.

In the end, things got rather busy and no-one told Sarah - the baby was born with a harmful condition that could be caused by: 1. the new method of delivery, 2. a genetic defect, 3. a tumour within the baby.  The journal article gave an opinion from other doctors who suggested that without this new procedure, there is s high risk of death to the mother and/ or child.  As it stands, the baby will need a fairly high level of medical attention for the whole of her life.

Before delivery, one of the junior doctors wanted to use a piece of equipment that he has previously used in a city hospital.  The other two doctors advise that this rural hospital doesn't have this resource.  In the past, one has been couriered 30 miles if needed, and the hospital manager thinks that it is too expensive to buy one compared to the use it would get.

During delivery, Sarah lost quite a lot of blood and needed a transfusion.  Someone had misplaced Sarah's notes and so a transfusion was given as an emergency measure.  Several weeks afterwards, a test showed that Sarah was HIV+.  She claims that this was a result of the transfusion, but the hospital staff are aware that she used to work as a prostitute before she fell pregnant.  Her local health centre have some records of HIV testing in the past that was negative which she is using to strengthen her claim.

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