Legal and ethical issues in midwifery: Random info

Question 1

What is the law governing midwifery practice

Answer 1

Common law

Question 2

What is ethics

Answer 2

Ethics is the study of what we ought to do. “How should I live”

Question 3

What ethical framework is most commonly used in healthcare and what are the four major principles.

Answer 3

Bioethics:
1. Autonomy: the right to self-determination, to control what happens to use. Ie client providing consent.
2. Beneficence: described as “above all, do good”
3. Non maleficence: “do no harm’, benefit outweighs the harm.
4. Justice: health care services are distributed fairly, justly and equitably

Question 4

ICM definition of a midwife

Answer 4

A person who has successfully completed a midwifery education program that is based on the ICM essential competencies for basic midwifery practice and the framework of the ICM global standards for midwifery education, and is recognised in the country where it is located, who has acquired the required qualifications.

Question 5

Aim of the code of ethics

Answer 5

Improve the standard of care provided to women, babies and families throughout the world through the development, education and appropriate utilisation of the professional midwife.

Question 6

What are the seven legal standards (principles) expected of a midwife.

Answer 6

Principle 1: Legal compliance, lawful behavior, mandatory reporting
Principle 2: Women centered practice which includes midwifery practice, decision making, informed consent
Principle 3: Cultural practice and respectful relationships
Principle 4: Professional behavior including professional boundaries
Principle 5: teaching supervising and assessing
Principle 6: Research in health
Principle 7: Health and Wellbeing

Question 7

Elements of consent

Answer 7

In order for consent to be legal and ethical a person needs capacity to give consent, Given freely and voluntarily, For a specific purpose and Based on adequate disclosure of information

1) Enable valid consent - Competence, Voluntariness
2) Enact valid consent - Decision, authorisation
3) Inform valid consent - Disclosure of information, understanding of information.

Question 8

How may consent be given

Answer 8

1) Implied
2) Expressly, verbally
3) Expressly, in writing

Question 9

Parens patriae

Answer 9

Power to act on behalf of a person who cannot act for themselves - jurisdiction in relation to minors.

Question 10

Abortion

Answer 10

Refers to the termination of pregnancy. Classified according to the stage of the pregnancy. Early abortion occurs at less than 22 weeks, late abortion after 22 weeks.

Question 11

Crimes act 1900

Answer 11

Prohibited the unlawful administration of a drug or the use of any other means to deliberately cause a woman to miscarry.

Section 82 of the crimes act - whosever being a woman with child, unlawfully administers to herself any drug or noxious thing, or unlawfully uses any instrument or other means, with intent in any such case to procure her miscarriage, shall be liable to penal servitude for ten years.

Section 83 - whosever unlawfully administers to or causes to be taken by any woman any drug or noxious thing, or unlawfully uses any instrument or other means to procure her miscarriage shall be liable to penal servitude for ten years.

As the legislation specifies unlawfully there may be circumstances where an abortion will be lawful and falls under the defence of necessity. The termination must be necessary, and the steps taken must be proportionate to the danger avoided.

Question 12

Abortion law reform act 2019

Answer 12

Medical practioner may perform a termination on a woman who is not more than 22 weeks pregnancy provided that informed consent has been given. Counselling may be given. Midwives and other health professionals can assist.

Terminations more than 22 weeks can be performed in an emergency to save the woman’s life, by a specialist medical practioner.

Question 13

Coroners act 2009

Answer 13

The ability of the coroner to investigate certain kinds of deaths or suspected deaths in order to determine the identity of the deceased person, the times and dates of their death and the manner and cause of their death. The coroner can make recommendations in relation to matters in connection with the death including recommendations concerning public health and safety.

Question 14

What deaths are reportable under the coroners act

Answer 14

1) violent or unnatural death
2) sudden death
3) suspicious or unnatural circumstances
4) not attended a doctor in the previous 6 months
5) where death was not a reasonably expected outcome
6) Died in or while temporarily absent from a mental health facility
7) deaths in custody
8) children in care

Question 15

Stillbirth under the coroners act 2009

Answer 15

Same definition as under the Birth, Deaths and Marriages Registration act 1995. Born after 20 weeks of pregnancy or weighing more than 400 grams at birth and no signs of life.

If there are signs of life at birth, then death occurs, this is defined as a neonatal death up until 28 days of completed life.

Question 16

Mandatory reporting

Answer 16

Mandatory reporting is a legislative requirement for selected classes of people (including midwives). Relevant legisaltion is the children and young persons (care and protection) act 1998

Question 17

Risk of significant harm (ROSH) concerns

Answer 17

a) basic physical or psychological needs not met or at risk of not being met
b) parents/caregivers have not or can’t arrange necessary medical care
c) parents/caregivers have not or can’t arrange education in accordance with the education act 1990
d) at risk of being physically or sexually abused or ill-treated
e) household with domestic violence causing risk of serious harm
f) child was the subject of a pre-natal report under section 25 of the act

Question 18

HCCC

Answer 18

Health care complaints commission deals with all matters that relate to conduct, professional performance, health and fitness to practice.

In case of serious public health issues, concerns about appropriate care, alleged gross negligence or disciplinary matters the HCCC must investigate and may refer to the director of public prosecutions to decide if to pursue the matter.

Question 19

Name the 7 standards for midwifery practice

Answer 19

1. Promotes health and wellbeing through evidence-based midwifery practice
2. Engages in professional relationships and respectful partnerships
3. Demonstrates capability and accountability for midwifery practice
4. Undertakes comprehensive assessments
5. Develops a plan for midwifery practice
6. Provides safety and quality in midwifery practice
7. Evaluates outcomes to improve midwifery practice

Question 20

List the 4 codes of ethics for midwives

Answer 20

I. Midwifery Relationships
II. Practice of midwifery
III. The professional responsibilities of midwives
IV. Advancement of midwifery knowledge and practice

Question 21

List the 7 principles of the code of conduct for midwives

Answer 21

Principle 1: Legal compliance
Principle 2: Woman centered practice
Principle 3: Cultural practice and respectful relationships
Principle 4: Professional behavior
Principle 5: Teaching supervising and assessing
Principle 6: Research in health
Principle 7: Health and wellbeing

Question 22

Human Research Ethics committee

Answer 22

To ensure ethical standards are maintained in research projects and protect the interests of the research participants, investigators and institutions.

Question 23

Section 62 of the coroners Act 2009

Answer 23

AA person who appears before a coroner but refuses to take an oath or affirmation is subject to receiving a penalty