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Ethics for Midwives
Introduction to Ethics
Our care for patients should be based on sound
judgement (or evidence based practice!!
some of this judgement is about having a strong sense
of what is right or wrong
having a strong sense of what we should be doing and
shouldn’t be doing as midwife
having a strong sense of what our priorities ought to
be
Ethical historical trend
Before 1939: Malpractice.
 Few standard and regulations.
1940-present: Increased surgery and life support measures.
 Develop in drugs (antibiotics), (analgesics) and others.
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Ethical historical trend (con.)
 Nurses more skilled in dealing with medical and
surgical cases.
 More care in standard and policy (code of ethics).
 Increased advanced technology increased specialization
in different studies.
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Increased public involvement in the community.
Progress nurses specialty.
Universities-degrees: autonomy.
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Definition of ethics
 Ethics originated from a Greek word “Ethos”
meaning custom, habit, conduct and also called
Moral Philosophy (science of morals) .
 Ethics is commonly defined as the philosophical
study of right action and wrong action
 Ethics includes duties and responsibilities.
 Ethics studies voluntary actions carried out with
sufficient knowledge and choice.
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Morals and Ethical
 The words "morals" and "ethical" originally mean much,
the same thing:
 Ethics came from Greek
 Morals came from Latin
• Both words refer to the general area of rights and wrongs
in theory and practice of human behavior.
• Distinction has grown up between "morals" and
"ethical".
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• Morals refer to the standards of behavior actually held
or followed by individuals and groups.
• Ethics refers to the science or study of morals and it is
an activity in the academic context(moral philosophy).
OR
Ethics:
Is a system of moral or philosophical principles that
direct the actions as being either right or wrong
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Morals or Morality
Morals or Morality refers to the following:
 The ownership of personnel values and rules of behavior
 Rules of conduct regulating our social interactions
 Culture-specific more grounded in religion/ ideology
 Ethics refers to the collective of beliefs and values
system of any moral community or professional group.
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Comparison of morals and ethics
Morals:
 Principles and rules of right conduct.
 Private and personal.
 Commitment to principles and values are defended in daily
life
Ethics:
 Formal reasoning process used to determine right conduct
 Professionally and publicly stated.
 Inquiry or study of principles and values
 Process of questioning and perhaps changing one’s morals
Why do midwifery need Ethics?
Ethics for midwife serve as a foundation for midwifery
ethical practice:
 It provides guidance for ethical relationships,
responsibilities, behaviors and decision-making
 It is to be used in conjunction with the professional
standards, laws and regulations that guide practice.
 The code serves as a means of self-evaluation and self-
reflection for ethical midwifery practice and provides a basis
for feedback and peer review.
Why do midwifery need Ethics?
 It also serves as an ethical basis from which midwives
can advocate for quality work environments that support
the delivery of safe, compassionate, competent and
ethical care.
 Midwives recognize the privilege of being part of a self-
regulating profession and have a responsibility to merit
this privilege.
Why do midwifery need Ethics?
 The code informs other health-care professionals as
well as members of the public about the ethical
commitments of the midwives and the responsibilities
midwives accept as being part of a self-regulating
profession.
Important Question In Ethics
 What do we mean by ethics?
 Why it is important to midwives?
 What are the major ethical issues facing the midwife in
today's world?
What makes an action (behavior) moral or not
What- The act itself
Why- The motive.
Circumstances: when, where, how, to
whom and how often.
The kinds of acts that are of interest to ethics
Those that we ought to do e.g. saving live
Those that we ought not to do e.g. harm other.
Those that we may either do or not do disconnect
mechanical ventilator .
The International Confederation of Midwives (ICM)
 The International Confederation of Midwives (ICM),
founded in 1919, currently represents a federation of
midwifery associations from 100 nations of the world.
The ICM and its members associations represent
the organized efforts of midwives in countries, to
speak for themselves on matters that affect the
occupation and the profession, and to speak out
with a unified voice about matters that affect the
health of women, families and communities
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The International Confederation of Midwives (ICM)
This includes advocacy for development of national
health strategies in all countries that would give
midwives and doctors complementary roles in
maternity care, as well as equal involvement
insetting public health policy (Högberg, 2004).
Definition of the Midwife
A midwife
Is a person who has successfully completed a midwifery
education program that is duly recognized in the
country where it is located & has
acquired the
requisite qualifications to be registered and/or legally
licensed to practice midwifery
Scope of midwifery Practice
The
midwife
is recognized as a responsible and
accountable professional who works in partnership with
women to give the necessary support, care and advice
before pregnancy, during
pregnancy, labour and the
postpartum period, to conduct births on the midwife’s
own responsibility and to provide care for the newborn
and the infant.
Scope of Practice
This care includes preventative measures, the
promotion of normal birth, the detection of
complications
in
mother and
child,
the
accessing of medical care or other appropriate
assistance and the carrying out of emergency
measures.
The midwife has an important task in health
counseling and education, not only for the woman,
but also within the family and the community.
This work should involve antenatal education and
preparation for parenthood and may extend to
women’s health, sexual or reproductive health and
child care
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Scope of Practice
A midwife may practice in any setting including the
home, community, hospitals, clinics or health units.
Skills of the midwife
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
Advising on health
Assessment
Managing care
Independent action
Initiating the action of others
Undertaking care prescribed by the doctor
Communication
Research awareness
Evidence based practice
A team member
Ethical issues
1. Advising on health
She deals with healthy women and her family
The midwife has a responsibilities toward herself
and her colleagues
Promote healthy living through the education both
before and after birth of a baby
2. Assessment
Take into account not just the physical parameters of
health but must recognize the social , emotional
and psychological factors influencing health
3. Managing care
 A midwife must be competent to diagnose the pregnancy
and carry out the examination of the women and their
babies
 She plan the necessary care ,implement the care and
evaluate the effectiveness of the plan which has been
carried out
4. Independent action
The midwife is the expert in normal midwifery and
has an obligation to care for the mother and the
baby
In emergency situation she is trained to take
immediate action to treat woman or baby while
summoning medical aids
5. Initiating the action of others
 The midwife may have need of the expertise and
intervention of other discipline
 Obstetrician and pediatrician may be called upon to give
aids when abnormalities arise
 Social worker , physiotherapist, dieticians are among
other professional to whom the midwife may refer in
appropriate circumstances
6.
Undertaking care prescribed by the doctor
 The duty of the midwife is to administer care and treatment
prescribed by the doctor .
 She is expected to interpret the orders ,question or even
challenging. She may argue the doctor to take an action.
when a midwife has called the doctor, the responsibilities
for the problem becomes his and there remains the a duty to
continue caring for the mother and the baby.
7. Communication
The skillful midwife develops effective
communication with her clients, colleagues and
those in other disciplines.
This involve enabling them to express their wishes
and views and exercising empathy toward them
8. Research awareness
As midwifery research grows year by year, it
becomes increasingly important for the competent
midwife to be alert to new knowledge that has
been established by research and to develop a
questioning attitude toward her own practice
9. Evidence based practice
The midwife responsibilities is to make use of all
available resources to inform her practice including
experiential knowledge .
She has a duty to weigh up the latest clinical evidence
that elicited by her personal observation and to take
account of her experiences and the woman’s wishes
10. A team member
Being an independent practitioner goes hand by
hand with membership of the multidisciplinary team
which existing to care for the mothers and the
babies.
The midwife must understand the roles of her
colleagues and build harmonious relationships with
them
11. Ethical issues
 The midwife must consider ethical matter as
maintaining confidentiality, maintaining and
improving one’s own professional competence, while
acknowledging any limitation.
 Promotion the clients' independence and respect them
as unique individuals
A profession usually has
Unique knowledge
A licensing process.
Having a code of ethics
Lengthily socialization
Autonomy of practice
Admission criteria
 University qualification
 A socially-required activity
Sharing asset of values about work
Commitment for professional development
Characteristics of midwifery profession
Midwifery profession requires an extended education
of its members, as well as a basic liberal foundation.
Midwifery profession has a theoretical body of
knowledge leading to defined skills, abilities and
norms.
Midwifery profession provides a specific service.
Members of a profession have autonomy in decisionmaking and practice.
The profession has a code of ethics for practice.