Thank you Marsha. Seems like you think this is a serious event, and not one
to be dismissed as a non-issue.  Your voice has been valued for a long time
in our profession, and I appreciate your comments, as I am sure many of our
readers do.

Kathleen


Kathleen Bruce RN IBCLC
Independent consultant:
Lactation Resources of Vermont, Medela, Inc. Listowner Lactnet listserv
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On 11/1/06 12:35 PM, "[log in to unmask]" <[log in to unmask]> wrote:

> I have just finished contributing as an expert witness in a law suit that
> involved discharging a non-feeding breastfed infant from the hospital and the
> resulting unfortunate outcome. One of the first set of documents I was asked
> to 
>  produce was the (old) LC standards of practice and the LC scope of
> practice. This was scrutinized by the attorney for failure of the LC to
> perform  what 
> was called for in these documents, part of which related to the LC's  failure
> to recommend to the physician that the baby not be discharged. Our duty  and
> obligation is to the patient (mother and baby), called  fidelity, not to who
> employs us or who we work with. Otherwise a conflict  of interest is created
> between the interests of the patient and the competing  interests. These new
> standards have bypassed the ethical underpinnings of our  profession:
> beneficence 
> and veracity (the moral obligation to provide complete  and accurate
> information) and non-maleficence (the obligation to avoid physical  or mental
> harm to 
> the patient). Non-maleficence also includes the obligation of  not imposing
> the 
> RISKS for harm, which these new Standards if Practice clearly  do. This
> ethical dilemma places us in a moral and legal bind right now. It  matters
> greatly 
> what those standards say and muzzling the LC with restrictive  language
> cripples our ability to discharge our obligation to the mothers and  babies
> entrusted to our care. It puts us in legal jeopardy as it pits one set of
> documents 
> against the other (IBLCE standards vs ILCA standards). The lawyers in  the
> above case would have had a field day with this.
>  
> How unfortunate that this situation has arisen from within the lactation
> community especially in light of two new articles that validate the importance
> of the IBCLC - the one that Liz just mentioned and the new article in the
> current Journal of Human Lactation by the president of ILCA:
>  
> Mannel R, Mannel RS. Staffing for hospital lactation programs:
> recommendations from a tertiary care teaching hospital. J Jum Lact 2006;
> 22:409-417
>  
> Let's hope for swift action on this and not a 2 year study of minutia.
>  
> Marsha Walker, RN, IBCLC
> Weston, MA
>  
>  
> 
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