This thing happens in every medical office - when the MD writes a prescription for a particular medicine or the chiropractor recommends something. Playing devil's advocate here - why is it ethical to market our services at all - or be paid? Shouldn't we just work for the cause? I know I'm getting ridiculous, but there are MANY who struggle with the morality of being paid to do "nature's" or if you will, "God's" work. We recommend our favorite brand of clothes or shoes or whatever. Is that ethical when there is not evidence to support the recommendation, other than our own subjective feelings about it? This is a deeper issue than just Medela or Ameda.
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Elizabeth Brooks
Sent: Sunday, March 08, 2009 7:23 PM
Subject: ethical business relationships with companies; Code again
We have many more IBLCE Code of Ethics Tenets to worry about than No. 24 (which addresses the WHO Code). My leisurely stroll thru the IBLCE Code of Ethics uncovered seven other Tenets that address our requirement, as IBCLCs, to conduct ourselves with integrity, and free of conflict-of-interest, in evidence-based aid of assisting mothers. (Tenets 1,4,5,11,12,16 and 17; see the full Code of Ethics at www.ilbce.org).
An IBCLC can conduct her practice quite ethically, thank you very much, without violating the WHO Code. Even if she has a retail or rental business. Even if she sells STUFF. Even if the STUFF -- gasp -- is one of the four product types that fall under the WHO Code. Offending product-types should be kept out of view ... so the mother has to ask for it. Put the rental pump (not covered by the WHO Code) and the nipple shield
(ditto) and the baby sling (ditto) and the bra (ditto) and the book (ditto) on your sales racks ... but put the boxes with the offending pictures of bottles-and-teats under your counter. Throw away the freebie brochures
(translation: mini product catalogues) from the WHO-Code-violating companies
-- and write your own. Heck, you're an IBCLC. Isn't this *your* specialty?
It is called the International Code of *Marketing* of Breast-milk Substitutes. *Sales* of the four product-types under the WHO Code re NOT prohibited. Inappropriate *marketing* of the four product types is prohibited.
Let's put this into an easier perspective. Let's talk about kangaroo, or skin-to-skin (s2s) care. Probably not an IBCLC on this list thinks that is a bad idea, right? Now, imagine I am an IBCLC, walking into the Level III NICU, to talk to the mother of the 30-weeker about the importance of skin-to-skin. I'm still a great IBCLC, right? Now I discuss how there are special shirts mom can buy to make it easier to perform s2s. Am I still ok? Yeah -- I think I probably pass the Smell Test.
But now I show mom a sample of such a shirt -- and tell her she can buy it directly from me, right now, 10% discount for cash sales, and please give the sales brochure to your family and friends. How many of you just said "OMG! No Way!"? I hope all of you -- and is has nuttin' to do with the WHO Code It has to do with the inherent conflict of interest in me pushing onto a mom the commerical sale of a product (regardless of the medical efficacy of the item).
And woe to those of you, who don't sell a darn thing, who think these issues don't affect them. Have you ever recommended a product, by brand name, to a mother? Without mentioning alternatives? Doesn't that make you *appear* to be endorsing the product? Is that acceptable under our IBLCE Code of Ethics? Under your own personal Smell Test?
--
Liz Brooks JD IBCLC
Wyndmoor, PA, USA
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