Gonneke points out the nub of the issue!

I think many elements of the IBLCE Code of Ethics, and IBLCE Scope of
Practice, are poorly drafted **from a legislative/legal** standpoint.   It
is not just an IBLCE thing.  It is hard for any person or organization to
draft rock-solid, fully applicable, totally fair laws and rules.  Heck --
here in the United States we have an entire branch of government (the
judicial) that takes on cases to interpret legislative language and
legislative intent.

So -- yes -- there are whole schools of medical ethical philosophy that
would question whether a health care provider should deny good,
evidence-based and compassionate care to a patient/client simply because the
mother has no HCP.  Or, to deny her care because she has a doctor, and asks
you not to share your report with the HCP.  (Read some of Lois Arnold's
great articles about the ethics notion of "autonomy").

And yet.

We are IBCLCs, and when we voluntarily agreed to sit for the IBCLC exam (and
all 22,000+ IBCLCs around the world voluntarily agreed to take it ....) we
agreed to abide by the rules established and enforced by our certifying
organization, including the Code of Ethics, complete with its language that
is vague, and leaves our ability to provide care without an HCP backstop
something of a muddle.

Hence, my suggestion for the back-door approach of providing evidence-based
compassionate care, and giving the mother a report to take with her.

But any IBCLC who feels uncomfortable doing this is absolutely within her
professional rights to forego the professional relationship with the client
in the first place.  We IBCLCs practice 22,000+ different ways.  Every
single medical profession allows an "out" for the clinician, **especially**
when a professional relationship has yet to be established, to choose not to
treat a patient/client.

-- 
Liz Brooks JD IBCLC FILCA
Wyndmoor, PA, USA

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