Dear all:
I have not been reading posts lately because I have been working on another important
task for our profession. So, I cannot make any comments about previous postings and
their positivity or negativity.
I will state that I feel our profession is in crisis and we have the responsibility to ensure
that we continue as an empowered profession, not one that is weakened to the point that
we have less freedom to discuss experience and evidence-based information than the
Director of Marketing at the pre and postnatal childbirth education center where I run
breastfeeding support groups. I thought about the IBCLE version of the SOP when the
Marketing Director was selling an herbal supplement and freely offering her opinion about
it. I realized that there were no restrictions on her saying whatever she pleased, but if I
opened my mouth I might jeopardize my IBCLC.
The crisis is that IBCLE has written a scope of practice that puts us in legal jeopardy due
to the contradictory wording. We cannot assume that a lawyer will put a positive spin on
this document. Cynthia Good Mojab wrote the most eloquent critique of the obvious
contradictions in this document. Anyone who has not read her critique should go through
the archives and read it. No lawyer will care if we choose to interpret these obvious
contradictions in a benign way. The legal questions that have never been answered by
the IBCLE to my knowledge are as follows:
1) Does the original SOP written by ILCA supercede the new SOP written by IBCLE?
2) Does an IBCLC who certified when the only SOP in existence was the one written by
ILCA have to follow the new SOP that was written by the IBCLE long after they certified?
3) Does the fact that the IBCLE removed the SOP from some of their websites mean that
they have temporarily rescinded that SOP?
4) If we choose to recertify (or certify) does this mean that by default we are agreeing to
accept the new SOP written by IBCLE?
Apart from the IBCLCs who are lawyers, the rest of us do not have a leg to stand on when
we "interpret" the potential legality of these questions.
Furthermore, a member of the IBCLE has specifically made a statement to me that other
lawyers I have talked to disagree with. I was told that it would be "restraint of trade" to
remove the certification of an IBCLC who directly took money from the formula industry.
In fact, as I understand this is not the case. Corporations themselves have rules and
regulations about "conflict of interest". Someone who works for a corporation who may
have access to clients, patents or other "intellectual property" of the corporation often
must sign contracts whereby they cannot take clients, patents, or other "intellectual
property" with them if they leave the corporation. Many corporations have tight rules and
regulations about "conflicts of interest". As I understand, trade is not restrained because
any IBCLC may go work for the formula industry if she or he so chooses. But that does
not necessarily mean that a certifying body cannot choose to remove the certification.
The fact that there is an entirely opaque process within the IBCLE and that there has been
little communication, and that someone who has direct ties to the nutritional
supplementation industry is extremely troubling because this represents a HUGE potential
for conflict of interests. How was this person chosen? Who chose this person? What
does a background in policy have to do with business management? Policy makers
review documents and develop policy statements. WHO is an example. The WHO really
does not run international development programs and in contrast to UNICEF does very
few interventions in countries. They are not the action arm. UNICEF is the action arm
that runs large scale programs. A business manager would be far more appropriate than
a policy maker, particularly a policy maker who has been working on policies for an
industry that is in direct competition with breastfeeding. We have every right to question
the ethical standards of our certifying body. This is not NEGATIVE, it is a positive,
proactive stance to ensure the survival of our profession. Burying our heads in the sand
and pretending that all is well and twisting ourselves into linguistic knots to come up with
some viable way to tell the truth about evidence based information is not the answer.
If we want our profession to survive as a serious profession, we need to find a way to
ensure that we have an IBCLE board that is responsive, transparent and free of conflicts
of interests. Without us, the IBCLE really would not exist.
Finally, there are many aspects of the IBCLE SOP that clearly restrain what IBCLCs can
do. I have not read a single SOP from any other profession that is so negative or
restrictive in its nature. Most SOPs are extremely postive in nature describing what the
professional can do, rather than what they cannot do. I believe that the IBCLE SOP is
extremely negative and we need to find constructive positive solutions to fix both the SOP
written by the IBCLE and to improve the ethical standards of the IBCLE board.
Best, Susan E. Burger
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