We need to make a distinction between obtaining the mother's consent to
touch and exam mother and baby as a function to avoid charges of assault
and battery, and the issue of whether the LC is functioning within a
legally defined scope of practice.

Every health professional should obtain consent, either verbally or in
writing, before touching a client/patient.  Such consent is given in
writing in the hospital admission papers, but obtaining verbal consent
for actions taken while caring for the individual respects that
individual's autonomy within the practice setting.  Obtaining consent in
this manner is a protection for the practitioner from charges of assault
and battery.

Many states have clauses which define what actions can be construed to
show that an individual is "practicing" medicine, nursing, or other of
the health care professions protected by licensure.  Licensure serves
two functions within our society:  1.  protection of the public from
those who would practice without appropriate preparation, and 2.
protection of the professional practices (read that business, as in $$$)
of those who have obtained certain "bodies of knowledge" from
encroachment by those who have "lesser" skills.  Okay, okay, there are
those who would argue that they are more concerned about "quality of
care" than they are $$$.

Thus when times are prosperous and those with "specialized knowledge"
are as busy as they want to be, those who might be viewed as
"encroachers" are generally safe from prosecution for "practicing
without a license."  But when times become more lean, one sees many more
prosecutions and much more concern about the appropriateness of one who
is using techniques which may fall into the specially protected
knowledge, ie, prosecution for "practicing medicine or nursing without a
license."

Another time when there becomes concern over "practicing without a
license" is when someone who is perceived to have lesser qualifications
challenges or tries to direct the practice of the one who perceives
himself to be more qualified.  We have probably all had experience with
the person who believes themselves to be better qualified, and yet like
Don Quixiote (sp?) is always seeing giants stalking him and strikes out
willy-nilly against others.  When LC's find themselves dealing with such
individual's it would behove them to tread lightly, especially if the
LC's underlying qualifications are not in a field with examination and
prescribing rights legally defined by law.

The consent of the mother to touch and exam herself and her baby
protects one from charges of assault and battery, but does not protect
against charges of "practicing without a license."

It is in the area of "practicing without a license" that the non-HCP LC
seeks protection through the use of skillful interpersonal
relationships, professional behavior, documentation that describes
findings but does not give "medical diagnoses", and couching one's
information given very carefully (not as prescribing, or orders, or even
a plan of care [nursing holds that right] but as a statement of other's
experiences and options that the mother or her HCP may want to
explore).  When dealing with HCP's the non-HCP LC can site relevant
literature which makes the recommendations that she would like to see
implemented, but she may have trouble if she makes the statement "My
recommendation would be . . ."

Hope this clarifies some of the issues raised.  I think I had a
flashback and was teaching NURSING 101, Legal Issues . . . .  Oh here I
am at my computer, hit send now, and get this off my screen! <VBG>

Melinda Hoskins, MS, RN