Legal and ethical issues in midwifery: Codes and standards Flashcards
Midwifery standards for practice: Standard 1
Promotes health and wellbeing through evidence-based midwifery practice.
1.1 Identifies what is important for woman as
the foundation for using evidence to
promote self-determination
1.2 Uses the best available evidence
1.3 Health assessment and education
1.4 Ongoing reflection
1.5 Supports access
1.6 Supports evidence-based health initiatives and programs.
1.7 Uses our role to influence better health outcomes
Midwifery standards for practice: Standard 2
Engages in professional relationships and respectful partnerships.
2.1 Supports the choices of women
2.2 Partners with women
2.3 Practices ethically
2.4 Practices without discrimination
2.5 Practices cultural safety
2.6 Practices in a way that respects the health of Aboriginal/Torres Strait Islander peoples.
2.7 Maintains professional relationships
2.8 Collaborative practice.
Midwifery standards for practice: Standard 3
Demonstrates the capability and accountability for midwifery practice
3.1 Understands their scope of practice
3.2 Practices within relevant legal parameters, professional standards, codes and guidelines.
3.3 Participates in professional development
3.4 Support learning and teaching.
3.5 Timely consultation, referral and documentation.
3.6 Identify and manage complexity and risk.
3.7 Recognizes where safety is compromised
3.8 Considers the health and wellbeing of self and others
Midwifery standards for practice: Standard 4
Undertakes comprehensive assessments
4.1 Determine factors that affects women’s health and wellbeing.
4.2 Systematically collect information
4.3 Analyses information and data and
communicates assessments
4.4 Assess the resources available
Midwifery standards for practice: Standard 5
Develops a plan for midwifery practice
5.1 Interprets evidence to make a plan for practice
5.2 Develops a plan with the woman.
5.3 Allocate resources effectively
5.4 Documents, evaluates and modifies plans.
Midwifery standards for practice: Standard 6
Provides safety and quality in midwifery practice
6.1 Contributes to quality improvement
and research
6.2 Meet the needs of the woman.
6.3 Consult, refer and escalate where needed.
6.4 Provides and accepts timely direction,
allocation, teaching and supervision
Midwifery standards for practice: Standard 7
Evaluates outcomes to improve midwifery practice.
7.1 Evaluates and monitors progress
7.2 Revises plan and actions
7.3 Uses evaluation to inform future practice
Code of ethics I Midwifery relationships
a. Midwives develop a partnership with women - share relevant information - leads to informed decision-making - consent - accept responsibility
b. Midwives support the right of women/families to participate actively in decisions about their care.
c. Midwives empower women/families to speak for themselves on issues affecting the health of women and families within their culture/society.
d. Midwives, together with women, work with policy and funding agencies to define women’s needs for health services and to ensure that resources are fairly allocated considering priorities and availability.
e. Midwives support and sustain each other in their professional roles, and actively nurture their own and others’ sense of self-worth.
f. Midwives respectfully work with other health professionals, consulting and referring as necessary when the woman’s need for care exceeds the competencies of the midwife.
g. Midwives recognise the human interdependence within their field of practice and actively seek to resolve inherent conflicts.
h. Midwives have responsibilities to themselves as persons of moral worth, including duties of moral self-respect and the preservation of integrity.
Code of ethics II Practice of midwifery
a. Midwives provide care for women and childbearing families with respect for cultural diversity while also working to eliminate harmful practices within those same cultures.
b. Midwives encourage the minimum expectation that no woman or girl should be harmed by conception or childbearing.
c. Midwives use up-to-date, evidence-based professional knowledge to maintain competence in safe midwifery practices in all environments and cultures.
d. Midwives respond to the psychological, physical, emotional and spiritual needs of women seeking health care, whatever their circumstances.
e. Midwives act as effective role models of health promotion for women throughout their life cycle, for families and for other health professionals.
f. Midwives actively seek personal, intellectual and professional growth throughout their midwifery career, integrating this growth into their practice.
Code of ethics III. The professional responsibilities of midwives.
a. Midwives hold in confidence client information in order to protect the right to privacy and use judgment in sharing this information except when mandated by law.
b. Midwives are responsible for their decisions and actions and are accountable for the related outcomes in their care of women.
c. Midwives may decide not to participate in activities for which they hold deep moral opposition; however, the emphasis on individual conscience should not deprive women of essential health services.
d. Midwives with conscientious objection to a given service request will refer the woman to another provider where such a service can be provided.
e. Midwives understand the adverse consequences that ethical and human rights violations have on the health of women and infants and will work to eliminate these violations.
f. Midwives participate in the development and implementation of health policies that promote the health of all women and childbearing families.
Code of ethics IV, Advancement of Midwifery Knowledge and practice
a. Midwives ensure that the advancement of midwifery knowledge is based on activities that protect the rights of women as persons.
b. Midwives develop and share midwifery knowledge through a variety of processes, such as peer review and research.
c. Midwives contribute to the formal education of midwifery students and ongoing education of midwives.
Code of conduct for midwives: Principle 1 Legal compliance.
Value: Midwives respect and adhere to professional obligations under the National Law and abide by relevant laws.
Code of conduct for midwives: Principle 1 Legal compliance. 1.1 Obligations
1.1 Obligations. Midwives must be aware of their obligations under the national law including reporting requirements and meeting registration standards.
a. Abide by any reporting obligations under the National Law and other relevant legislation.
b. Inform the Australian Health Practioner Regulation Agency and their employers if a legal or regulatory entity has imposed restrictions on their practice, including limitations, conditions, undertakings, suspension, cautions or reprimands and recognised that a breach of any restriction would place the public at risk and may constitute unprofessional conduct of professional misconduct.
c. Complete the required amount of continuing professional development relevant to their context of practice.
d. Ensure their practice is appropriately covered by professional indemnity insurance.
e. Inform Ahpra of charges, please and convictions relating to criminal offences.
Code of conduct for midwives: Principle 1 Legal compliance. 1.2 Lawful behavior
1.2 Lawful behaviour. Midwives practice honestly and ethically and should not engage in unlawful behaviour as it may affect their practice and/or damage the reputation of the profession.
a. Respect the midwife-woman professional relationship by not taking possessions and/or property that belong to the woman and/or her family.
b. Comply with relevant poisons legislation, authorisation, local policy and own scope of practice, including to safely use, administer, obtain, possess, prescribe, sell, supply and store medications and other therapeutic products.
c. Not participate in unlawful behaviour and understand that unlawful behaviour may be viewed as unprofessional conduct or professional misconduct and have implications for their registration.
d. Understand that making frivolous or vexatious complaints may be viewed as unprofessional conduct or professional misconduct and have implications for their registration.
Code of conduct for midwives: Principle 1 Legal compliance. 1.3 Mandatory reporting
Caring for those who are vulnerable brings legislative responsibilities for midwives including the need to abide by relevant mandatory reporting requirements as they apply across individual states and territories.
a. Abide by the relevant mandatory reporting legislation that is imposed to protect groups that are particularly at risk, including reporting obligations about the aged, child abused and neglect and remaining alert to the newborn and infants who may be at risk.
b. Remain alert to other groups who may be vulnerable and at risk of physical harm and sexual exploitation and act on welfare concerns where appropriate.
Code of conduct for midwives: Principle 2 Woman-centred practice
Value: Midwives provide safe, woman-centred, evidence-based practice for the health and wellbeing of women and, in partnership with the woman, promote shared decision-making and care delivery between the woman, nominated partners, family, friends and health professionals.
Code of conduct for midwives; Principle 2 woman-centred practice. 2.1 Midwifery practice.
Midwives apply woman-centred and evidence-based decision-making and have a responsibility to ensure the delivery of safe and quality care.
a. Practice in accordance with the standards of the profession and broader health system
b. Provide leadership to ensure the delivery of safe and quality care and understand their professional responsibility to protect women, ensuring employees comply with their obligations
c. document and report concerns if they believe the practice environment is compromising the health and safety of women receiving care.
Code of conduct for midwives; Principle 2 woman-centred practice. 2.2 Decision making.
Making decisions about healthcare is the share responsibility of the woman, the midwife and other health professionals. Midwives should create and foster conditions that promote shared decision-making and collaborative practice
a. Take a woman-centred approach to managing a woman’s care and concerns, supporting the woman a manner consistent with that woman’s values and preferences.
b. advocate on behalf of the woman where necessary and recognise when substitute decision-makers are needed.
c. supports the right of women to seek second and/or subsequent opinions or the right to refuse treatment/care
d. recognise that care may be provided to the same woman by different midwives, and by other members of the healthcare team, at various times.
e. recognise and work within their scope of practice which is determined by their education, training, authorisation, competence, qualifications and experience, in accordance with local policy.
f. recognise when an activity is not within their scope of practice and refer women to another health practioner when this is in the best interests of the woman receiving care.
g. takes reasonable steps to ensure any woman to whom a midwife delegates, refers or hands over care has the qualifications, experience, knowledge, skills and scope of practice to provide the care needed.
h. recognise that their context of practice can influence decision-making. This includes the type and location of practice setting, the characteristics of the woman receiving care, the focus of midwifery activities, the degree to which practice is autonomous and the resources available.
Code of conduct for midwives; Principle 2 woman-centred practice. 2.3 Informed consent.
Informed consent is a woman’s voluntary agreement to healthcare, which is made with knowledge and understanding of the potential benefits and risks involved.
a. supports the provision of information to the woman about her care in a way and/or in a language they can understand, through the utilisation of translating and interpreting services, when necessary. This includes information on examinations and investigations, as well as treatments.
b. give the woman adequate time to ask questions, make decisions and to refuse care, interventions, investigations and treatments, and proceed in accordance with the woman’s choice, considering local policy.
c. act according to the woman’s capacity for decision-making and consent, including when caring for children and young people, based on her maturity and capacity to understand, and the nature of the proposed care.
d. obtains informed consent or other valid authority before carrying out an examination or investigation, provide treatment, or involving women in teaching or research.
e. informs the woman of the benefit as well as associated costs or risks, if referring the woman for further assessment, investigations or treatments, which they may want to clarify before proceeding.
Code of conduct for midwives; Principle 2 woman-centred practice. 2.4 Adverse events and open disclosure.
When a woman is harmed by healthcare, midwives have responsibilities to be open and honest in communicating with the woman, to review what happened, and to report the event in a timely manner, and in accordance with local policy.
a. recognise and reflect on what happened and report the incident.
b. act immediately to rectify the problem if possible and intervene directly if it is needed to protect the woman’s safety. Including escalating concerns if needed.
c. abides by the principles of open disclosure and non-punitive approaches to incident management.
d. identifies the most appropriate healthcare team member to provide an apology and an explanation to the woman, as promptly and completely as possible, that supports open disclosure principles
e. listens to the woman, acknowledge any distress they experienced and provide support. In some cases, it may be advisable to refer the woman to another midwife or health professional.
f. ensure woman have access to information about how to make a complaint, and that in doing so, not allow a compliant or notification to negatively affect the care they provide.
g. seek advice from their employer, their professional indemnity insurer, or other relevant bodies, if they are unsure about their obligations.
Code of conduct for midwives; Principle 3 Cultural practice and respectful relationships
Value: Midwives engage with women as individuals in a culturally safe and respectful way, foster open, honest and compassionated professional relationships, and adhere to their obligations about privacy and confidentiality.
Code of conduct for midwives; Principle 3 Cultural practice and respectful relationships. 3.1 Aboriginal and Torres Strait Islander peoples’ health
a. provide care that is holistic, free of bias and racism, challenges belief based upon assumption and is culturally safe and respectful for Aboriginal and Torres Strait Islander peoples.
b. advocate for and act to facilitate acccess to quality and culturally safe health services for Aboriginal and Torres Strait Islander peoples
c. recognise the importance of family, community, partnership and collaboration in the healthcare decision-making of Aboriginal and Torres Strait Islander peoples.
Code of conduct for midwives; Principle 3 Cultural practice and respectful relationships. 3.2 Culturally safe and respectful practice
Culturally safe and respectful practice requires having knowledge of how a midwives’ own culture, values, attitudes, assumptions and beliefs influence their interactions with women and families, the community and colleagues.
a. understands that only the woman and/or her family can determine whether or not care is culturally safe and respectful.
b. respects diverse cultures, beliefs, gender identifies, sexualities and experiences of women and others, including among team members
c. acknowledges the social, economic, cultural, historic and behavioral factors influencing health, both at the individual community and population levels.
d. adopts practices that respect diversity, avoid bias, discrimination and racism, and challenge belief based upon assumption.
e. support an inclusive environment for the safety and security of the individual woman and her family and/or significant others
f. creates a positive, culturally safe work environment through role modelling, and supporting the rights, dignity and safety of others, including women and colleagues.
Code of conduct for midwives; Principle 3 Cultural practice and respectful relationships. 3.3 effective communication
Positive professional relationships are built on effective communication that is respectful, kind, compassionate and honest
a. be aware of health literacy issues and take health literacy into account when communicating with women.
b. makes arrangements, whenever possible, to meet the specific language, cultural, and communication needs of women and their families through the utilisation of translating and interpreting services where necessary and be aware of how these needs affect understanding
c. endeavor to confirm the woman understands any information communicated to them
d. clearly and accurately communicates relevant and timely information about the woman to colleagues, within the bounds of relevant privacy requirements
e. be non-judgmental and not refer to women in a non-professional manner verbally or in correspondence/records, including refraining from behaviour that may be interpreted as bullying or harassment and/or culturally unsafe.