The Association of Texas Midwives
Code for Ethical Midwifery Practice
The Association
of Texas Midwives was established, in part, to further the goal of safe midwifery
care in Texas. The adoption of a code of ethics is one way of achieving that goal.
Additionally, the observance of ethical standards increases an awareness of midwifery,
by both current and future practitioners, as a unique calling, responsive to the
needs of birthing women. Finally, articulation of ethical standards is essential
to the recognition of midwifery as a profession by the broader society.
For
these reasons, the Association of Texas Midwives set forth the following CODE
FOR ETHICAL MIDWIFERY PRACTICE.
A.
CLIENT RIGHTS
An ethical midwife will respect the personal rights of her
clients, including:
1.
the right to be treated with respect and dignity without reference to age, marital,
socioeconomic, ethnic, national, political, mental, physical or religious status.
2. the right to use informed choice in her care, by having access to relevant
information upon which to base decisions.
3. the right to freedom from coercion
in decision making.
4. the right to accept or to refuse treatment.
5.
the right to full disclosure of financial factors involved in her care.
6.
the right to know who will participate in her care and to obtain additional consultation
of her choice.
7. the right not to be abandoned, neglected, or discharged
from care without opportunity to find other care.
8. the right to absolute
privacy except where this right is preempted by law.
B.
MIDWIFE RIGHTS
A midwife recognized the importance of respect for her
own rights as a care provider, including:
1. the right to refuse care to clients with whom
no midwife/client relationship has been established.
2. the right to discharge
clients from her care, provided adequate referral to other care is extended.
3. the right to receive honest, relevant information from clients upon which to
base care.
4. the right to receive reasonable compensation for services rendered.
C. MIDWIFE RESPONSIBILITIES
A midwife recognizes certain obligations and responsibilities which are intrinsic
to ethical midwifery practice, including:
1. the obligation to serve as the guardian of normal
birth, alert to possible complications, but always on guard against arbitrary
interference in the birthing process for the sake of convenience or the desire
to use human beings in scientific studies and training.
2. the obligation
to honor the confidence of those encountered in the course of midwifery practice
and to regard everything seen and heard as inviolable, remembering always that
a midwife's highest loyalty is owed to her client and not to her own reputation
or to her health care providers.
3. the obligation to provide complete, accurate
and relevant information to the client so that she can make informed choices regarding
her health care.
4. the obligation, when referring a client to another health
care provider, is to remain responsible for the client until she is either discharged
or formally transferred.
5. the obligation never to comment on another midwife's
or other health provider's care without first contacting that practitioner personally.
6. the responsibility to develop and utilize a safe and efficient mechanism for
medical consultation, collaboration and referral.
7. the obligation to continue
professional development through ongoing evaluation of knowledge and skills, and
continuing education, including diligent study of all subjects relevant to midwifery
practice.
8. the responsibility to assist others who wish to become midwives
by honestly and accurately evaluating their potential and competence, and sharing
midwifery knowledge and skills, to the degree possible without violating another
section of this Code.
9. the obligation to know and comply with all legal
requirements related to midwifery practice within the state of Texas, and to work
within the law to provide for the unobstructed practice of midwifery within the
state.
10. the responsibility to maintain accountability for all midwifery
care delivered under her supervision. Assignment and delegation of duties to other
midwives or apprentices should be equal to their educational preparation and demonstrated
proficiency.
11. the obligation to accurately document the client's history,
condition, physical progress and other vital information obtained during client
care.
D. UNPROFESSIONAL
CONDUCT
Conduct by a midwife which is likely to deceive, defraud, or injure
clients, or which results from conscious disregard for the health and welfare
of the client under the midwife's care, includes:
1. knowingly or consistently
failing to accurately document a client's condition, responses, progress, or other
information obtained during care. This includes failing to make entries, destroying
entries, or making false entries in records pertaining to midwifery care.
2. performing or attempting to perform midwifery techniques or procedures in which
the midwife is untrained by experience or education.
3. failing to give care
in a reasonable and professional manner, including maintaining a client load,
which does not allow for personalized care by the primary attendant.
4. leaving
a client intrapartum without providing adequate care for the mother and infant
(abandonment).
5. delegation of midwifery care or responsibilities to a person
who lacks the ability or knowledge to perform the function or responsibility in
question.
6. manipulating or affecting a client's decisions by withholding
or misrepresenting information, in violation of the client's right to make informed
choices in her health care.
7. failure to report to the applicable state board
or the appropriate authority in the Association, within a reasonable time, the
occurrence of any violation of any legal or professional code.
E. VIOLATIONS
Violations of this Code should be reported to the Association
for investigation through the Grievance Procedure. Findings from this investigation
will be used to assist the midwife in improving her practice, and to restrict
incompetent practitioners if necessary.
