โ Scribed by Joyce Beebe Thompson; Tekoa L. King
No coin nor oath required. For personal study only.
What do you do if you perceive a conflict of interest between yourself and your patient, or perhaps more commonly, a conflict between your professional judgment and the protocols used by the institution where you practice? All formal health care professions have codes of ethics that are, in essence, statements of ideal practice or behavior. Codes of ethics are used to inform ethical conflicts but perhaps more importantly, they are useful to us in developing our professional role whether it is a clinical, teaching, or administrative "hat" we are wearing.
Two American philosophers, Beachamp and Childress, 1 formulated the classic "Four Principles" of ethics: 1) respect to autonomy, 2) justice, 3) beneficence, and 4) non-maleficence. Most formal codes of ethics apply these four principles to the area of professional practice under discussion in that specific code. One of the great strengths of midwifery is that the profession includes a scope of practice that overlaps other professional boundaries. There are elements of nursing, obstetrics, lactation consultants, and social work (just to name a few) within the scope of midwifery practice. Table 1 lists Web sites and other resources that contain codes of ethics that may be helpful for specific situations in which a slightly different professional view could be of value.
The American College of Nurse-Midwives Code of Ethics 2 is currently under revision and will be published in a subsequent issue of this journal. The International Confederation of Midwives Code of Ethics, 3 revised in 1999, is republished in this column. This code of ethics is written for all midwives in all countries. As such, it provides an umbrella for midwifery practice regardless of the country of origin. In addition to the code itself, the ICM Web site includes a glossary of the terms used, the ethical analysis of the Code, a brief history of the development of the Code, and suggestions on how the midwife can use this Code in practice, education, or research. The full text of the code and supporting documents can be found on the ICM Web site at http://www.internationalmidwives.org.
๐ SIMILAR VOLUMES
There is a paucity of literature specifically addressing the efficacy of collaborative practices composed of midwives and physicians. However, the literature documenting the effectiveness of interdisciplinary teams of various health care providers combined with the literature on the effectiveness of