I think my analogy of car mechanics and ethics was a bust :)  I am impressed
that so many people have faith and trust in their car mechanics.  My dad was
an auto mechanic (as well as a computer technician) and he has some stories
about repair jobs done by car mechanics who bent their ethics a bit (maybe more
than a bit).  I still believe that when it comes to deciding upon a car
mechanic I would pick the shop that wasn't selling auto parts but was just offering
auto repair.

There is no shame in making money.  But I would suggest that there may be
difficult decisions to be made when you sell products as well as a service.  For
instance, a mom comes to you with a problem.  Her problem would simply be
resolved by nursing more often.  But she insists that she needs one of your top of
the line breast pumps (akin to patients insisting to docs that they need an
antibiotic for a viral infection).  If you are a rental station, you may need
to have a majority of your pumps rented in order not to lose money.  Will you
tell the mother that she doesn't need the pump and she needs to go elsewhere if
she insists about obtaining a pump?  Will you tell the mother that she
doesn't need the pump but rent to her anyway?  Will you just rent her the pump
without argument?  This situation actually happened to me and I found myself swayed
by the fact that I needed that pump to be rented to break even.  It was
profoundly disturbing to me that my need to pay the rental company for having
rental pumps could tempt me to change what I had to say or not say to a mom.  It
was one of the reasons I got out of renting pumps.

I would not be upset in the slightest if hospitals got out of the pump rental
business.  Their involvement has certainly caused many private rental
businesses to go belly up.  And if that is the basis of a lactation program, then the
hospital has no real investment in breastfeeding but just in the
profit-making angle of breastfeeding.

What do mothers assume when they spend hundreds of dollars on breastfeeding
equipment and it doesn't work?   Does selling products encourage mothers to
believe that the answer to the problem resides outside themselves?  The USA is a
culture that believes that buying a product answers a problem.  But I would
suggest that in many cases the problem is not resolved without a change in a
mother's perception.

Ellen Shein's post reminds us that faith and trust are important ingredients
between professionals and consumers.  This occurs when consumers/clients
believe that you are looking out for their best interest.  Sometimes, though, this
faith and trust is breached because the consumer/client may wrongfully or
rightfully believe that you only interest in them is to make money.
Valerie W. McClain, IBCLC


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