Sometimes when there is silence in response to a particularly eloquent post
(such as Magda's about ethics) it means that the point has been so well made
that there is no argument.  I don't think the silence expresses either
disagreement or disinterest.  However, Magda is right:  Discussion of ethics
is something that needs to happen on an on-going basis. I like to remind
people that a portion of the IBLCE exam grid concerns ethics, and when one
is certified as an IBCLC, one agrees toabide by the IBLCE Code of Ethics.
For many years I have advocated for ethics presentations at all major bfg
conferences.

It is critical for LCs to be aware of conflict of interest, and to declare
their associations.  For instance, I do occasional tech writing for Medela
(for pay as a consultant.)  Also, for years I have commented in print and at
every other opportunity on the pump and shield designs of various company's
products in hopes of improving them (never accepted any pay for this).   I
try to be very careful when I lecture to refer to products by their generic
rather than product names.  In other words, to say:  feeding tube device,
rental grade pump, etc rather than promote one product over another when the
products seem to me to be equivalent in quality (based on my observations
and hopefully also on research done by someone other than the company of
manufacture).  Sometimes there hasn't been an alternative and to describe
the piece of equipment one has had to say its product name (e.g. a Haberman
feeder).  When I lecture and show photos of equipment, I try to vary the
visuals to include photos of different equivalent brands so that my talks on
alternative feeding methods don't come across as a promotion of one company
over another.  We have to be scrupulous to not serve as unpaid marketing
reps for pump companies if we are going to gripe about other health care
professionals shilling for formula companies.

There are articles in the medical literature written by ethicists which
describe under what circumstances it is ethical to sell products out of the
office of an HCP.  I gave a presentation on this called "Are Plastics Part
of the Practice" at the Acapulco ILCA conf.  We've also talked about this on
Lactnet previously (see Archives). This is another area where we still are
working out the ethics of practice.

I think that on-going discussion of these issues is important and I thank
Magda for bringing it up again.  I certainly am glad to see the discussion
in the medical profession.  We should be part of it.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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