I think that it would be a good idea to include seminars on ethics at our
professional meetings.  I called for this several years ago in an editorial
I wrote for JHL on this subject.  I think that our professional conduct in
the counseling of equipment use is part of our role as LCs and ought to be
closely examined.

  The bald truth is that very few LCs can make a living (at least in private
practice) just on consultations.  I can't.  As much as I have framed my life
on behaving and serving mothers as a clinical practicioner, the truth is
that were it not for my rental depot I would not have been able to make even
the living I make now. Because of the quality of the rental pumps, and the
number of women with legitimate need of them, I felt ethically ok about
providing that service (always with lots of free counseling and often
talking people out of pumps.)  I have resisted the urgings of the major pump
and other companies to go more into retail, and it has been finanacially a
bad decision, especially with the demise of the rental market since the
advent of PNS pumps.  However, I think it is a professional mistake for LCs
to be viewed more for marketing products  than for managing breastfeeding.
I want to be seen as a health professional with specialized knowledge, and
to be reasonably compensated for it apart from my ability to counsel on
bras, pumps and gadgets.

However, a part of what a practioner needs to know is how to appropriately
evaluate and utilize gadgets and pumps when needed. The ethical part is the
"WHEN NEEDED".  We are all to subscribe to a professional code of conduct
which means that, like our dentists, optomitrists, etc, we only use
equipment when called for, not out of a profit motive.  Have I encountered
mothers who have felt "hustled" by LCs for items?  Yes.  Frequently?  No.
But if this is a slippery slope, then we need to confront the dilema
directly and address it with discussion, clarifications of boundries and set
guidelines -- esp. for newcomers.  Our annual professional meetings and our
professional publications are logical places for this.  Our local ILCA
affiliates could plan a meeting on this subject as well, and this would
stimulate lots of healthy introspection.  Our LC code of ethics describes
disciplinary action for LCs violating our Standards of Practice.  When we
use the name IBCLC we must represent our own codes impeccably.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html