Anti-vaccine nurses and midwives 6

Ellen Thirley is a registered nurse and registered midwife from the NSW central coast.

Thirley 21 AHPRA registrations nurse and midwife

Thirley states her profession and employment history on her Facebook profile:

Thirley 7 profile December 6 2015 midwife RDH

Thirley first came to our attention on the Facebook page of the discredited anti-vaccination organisation, the Australian Vaccination-skeptics Network: an organisation with a public health warning against its name.

On April 3 2015, Thirley discussed her misguided refusal to immunise herself – as per NSW Health employment requirements – with the AVN’s veteran anti-vaccination activist, Jane Beeby:

Thirley 1 AVN page registered nurse Beeby

On April 27 2015, on her Facebook profile, Thirley shared the anti-vaccine petition created by the disreputable Sally Elkordy:

Thirley 8 Elkordy petition April 2015

On May 9 2013, on her profile, Thirley shared a dishonest anti-vaccination petition from the AVN:

Thirley 10 2013 Dorey AVN petition

On March 6 2012, on her profile, Thirley shared this dishonest, Gardasil anti-vaccination post:

Thirley 12 2012 Gardasil

As we can see, Thirley has been sharing incorrect, anti-vaccination misinformation for a long period. Although not commenting very often on the AVN page, Thirley has been supporting the AVN for many years.

On April 28 2015, Thirley liked this anti-vaccination, conspiracy post:

Thirley 13 AVN April 28 2015 NN OP

Thirley 14 AVN April 28 2015 liked NN screed

On May 1 2015, Thirley liked this anti-vaccine post which asserts that vaccines cause autism:

Thirley 15 AVN May 1 2015 OP

Thirley 16 AVN May 1 2015

On May 23 2015, Thirley liked this conspiracy theory post which states that vaccination is a hoax:

Thirley 17 AVN May 23 2015 OP vaccine hoax

Thirley 18 AVN May 23 2015

On November 12 2011, Thirley liked this post which misinforms about the chicken pox vaccine:

Thirley 19 AVN 2011

Thirley 20 AVN 2011

Thirley also shares misinformation about dental amalgams, on her profile.

From May 9 2013:

Thirley 9 2013 dental amalgam

From April 26 2013:

Thirley 11 2013 dental amalgam

Complaints about Thirley’s activities can be made to the Nursing and Midwifery Board of Australia, here.

Thanks for reading.

The following addenda contain codes and guidelines, social media policy, and guidleines for advertising, from the NMBA.

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Addendum 1

Nursing and Midwifery Board of Australia Codes and Guidelines.

Code of Professional Conduct for Nurses in Australia

1 Nurses practise in a safe and competent manner.

2 Nurses practise in accordance with the standards of the profession and broader health system.

Conduct Statement 2

Nurses practise in accordance with the standards of the profession and broader health system

Explanation

1 Nurses are responsible for ensuring the standard of their practice conforms to professional standards developed and agreed by the profession, with the object of enhancing the safety of people in their care as well as their partners, family members and other members of the person’s nominated network. This responsibility also applies to the nurses’ colleagues.

2 Nurses practise in accordance with wider standards relating to safety and quality in health care and accountability for a safe health system, such as those relating to health documentation and information management, incident reporting and participation in adverse event analysis and formal open disclosure procedures.

3 Nurses practise and conduct themselves in accordance with laws relevant to the profession and practice of nursing.

Conduct Statement 3

Nurses practise and conduct themselves in accordance with laws relevant to the profession and practice of nursing

Explanation

1 Nurses are familiar with relevant laws and ensure they do not engage in clinical or other practices prohibited by such laws or delegate to others activities prohibited by those laws.

2 Nurses witnessing the unlawful conduct of colleagues and other co-workers, whether in clinical, management, education or research areas of practice, have both a responsibility and an obligation to report such conduct to an appropriate authority and take other appropriate action as necessary to safeguard people and the public interest.

4 Nurses respect the dignity, culture, ethnicity, values and beliefs of people receiving care and treatment, and of their colleagues.

5 Nurses treat personal information obtained in a professional capacity as private and confidential.

6 Nurses provide impartial, honest and accurate information in relation to nursing care and health care products.

Conduct Statement 6

Nurses provide impartial, honest and accurate information in relation to nursing care and health care products

Explanation

1 When nurses provide advice about any care or product, they fully explain the advantages and disadvantages of alternative care or products so individuals can make informed choices. Nurses refrain from engaging in exploitation, misinformation or misrepresentation with regard to health care products and nursing care.

2 Nurses accurately represent the nature of their services or the care they intend to provide.

3 Where a specific care or a specific product is advised, nurses ensure their advice is based on adequate knowledge and not on commercial or other forms of gain. Deceptive endorsement of products or services or receipt of remuneration for products or services primarily for personal gain, other than remuneration in the course of a proper commercial relationship, is improper.

7 Nurses support the health, wellbeing and informed decision-making of people requiring or receiving care.

8 Nurses promote and preserve the trust and privilege inherent in the relationship between nurses and people receiving care.

Conduct Statement 8

Nurses promote and preserve the trust and privilege inherent in the relationship between nurses and people receiving care

Explanation

1 An inherent power imbalance exists within the relationship between people receiving care and nurses that may make the persons in their care vulnerable and open to exploitation. Nurses actively preserve the dignity of people through practised kindness and respect for the vulnerability and powerlessness of people in their care. Significant vulnerability and powerlessness can arise from the experience of illness and the need to engage with the health care system. The power relativities between a person and a nurse can be significant, particularly where the person has limited knowledge; experiences pain and illness; needs assistance with personal care; belongs to a marginalised group; or experiences an unfamiliar loss of self-determination. This vulnerability creates a power differential in the relationship between nurses and persons in their care that must be recognised and managed.

4 Nurses fulfil roles outside the professional role, including those as family members, friends and community members. Nurses are aware that dual relationships may compromise care outcomes and always conduct professional relationships with the primary intent of benefit for the person receiving care. Nurses take care when giving professional advice to people with whom they have a dual relationship (e.g. a family member or friend) and advise them to seek independent advice due to the existence of actual or potential conflicts of interest.

9 Nurses maintain and build on the community’s trust and confidence in the nursing profession.

Conduct Statement 9

Nurses maintain and build on the community’s trust and confidence in the nursing profession

Explanation

1 The conduct of nurses maintains and builds public trust and confidence in the profession at all times.

2 The unlawful and unethical actions of nurses in their personal lives risk adversely affecting both their own and the profession’s good reputation and standing in the eyes of the public. If the good standing of either individual nurses or the profession were to diminish, this might jeopardise the inherent trust between the nursing profession and the public necessary for effective therapeutic relationships and the effective delivery of nursing care.

3 Nurses consider the ethical interests of the nursing profession and the community when exercising their right to freedom of speech and participating in public, political and academic debate, including publication.

10 Nurses practise nursing reflectively and ethically.

Conduct Statement 10

Nurses practise nursing reflectively and ethically

Explanation

1 Nurses practise nursing reflectively and ethically, in accordance with the Code of Ethics for Nurses in Australia, in order to learn from experience and contribute to personal and professional practice.

2 Nurses develop and maintain appropriate and current quality nursing advice, support and care for each person requiring and receiving care and their partners, families and other members of their nominated social network. This responsibility also applies to colleagues of nurses.

3 Nurses evaluate their conduct and competency according to the standards of the nursing profession.

4 Nurses contribute to the professional development of students and colleagues.

5 Nurses participating in research do so in accordance with recognised research guidelines and do not violate their duty of care to persons receiving nursing care.

6 Nurses advise employers and any persons in their care of any reduction in their capacity to practise due to health, social or other factors, while they seek ways of redressing the problem.

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Code of Ethics for Nurses in Australia

1 Nurses value quality nursing care for all people.

2 Nurses value respect and kindness for self and others.

3 Nurses value the diversity of people.

4 Nurses value access to quality nursing and health care for all people.

5 Nurses value informed decision-making.

Value Statement 5

Nurses value informed decision-making

Explanation

Nurses value people’s interests in making free and informed decisions. This includes people having the opportunity to verify the meaning and implication of information being given to them when making decisions about their nursing and health care. Nurses also recognise that making decisions is sometimes constrained by circumstances beyond individual control and that there may be circumstances where informed decision making cannot always be fully realised.

6 Nurses value a culture of safety in nursing and health care.

Value Statement 6

Nurses value a culture of safety in nursing and health care

Explanation

Valuing a culture of safety involves nurses actively engaging in the development of shared knowledge and understanding of the crucial importance of safety in contemporary health care. Nurses who value a culture of safety appreciate that safety is everyone’s responsibility. Nurses support the development of risk management processes and a practice environment designed to reduce the incidence and impact of preventable adverse events in health care. Nurses also support the open disclosure of any adverse events to any person affected during the course of their care.

7 Nurses value ethical management of information.

8 Nurses value a socially, economically and ecologically sustainable environment promoting health and wellbeing.

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Addendum 2

Code of professional conduct for midwives

Midwives practise competently in accordance with legislation, standards and professional practice

1 Midwives practise in a safe and competent manner.

Conduct statement 1

Midwives practise in a safe and competent manner

Explanation

1 Midwives are personally accountable to the woman and her infant(s); their employer and their profession for the provision of safe and competent midwifery care. It is the responsibility of each midwife to maintain the competence necessary for current practice. Maintenance of competence includes participation in ongoing professional development to maintain and improve knowledge, skills and attitudes relevant to practice in a clinical, management, education or research setting.

2 Midwives practise in a manner that recognises the woman’s right to receive accurate information; be protected against foreseeable risk of harm to themselves and their infant(s); and have freedom to make choices in relation to their care.

3 Midwives practise within the scope of midwifery, according to the International Confederation of Midwives Definition of the Midwife (2005).

6 Midwives make known to an appropriate person or authority any circumstance that may compromise professional standards, or any observation of questionable, unethical or unlawful practice, and intervene to safeguard the individual if the concern is unresolved.

2 Midwives practise in accordance with the standards of the profession and broader health system.

Conduct statement 2

Midwives practise in accordance with the standards of the profession and broader health system

Explanation

1 Midwives practise in partnership with the woman, and in accordance with the standards of the profession (e.g. the Board-approved National competency standards for the midwife), to provide safe and effective midwifery care.

2 Midwives practise in accordance with wider standards relating to safety and quality in midwifery care and accountability for a safe health system, such as those relating to health documentation and information management, incident reporting and participation in adverse event analysis and formal open disclosure procedures.

3 Midwives practise and conduct themselves in accordance with laws relevant to the profession and practice of midwifery.

Conduct statement 3

Midwives practise and conduct themselves in accordance with laws relevant to the profession and practice of midwifery

Explanation

1 Midwives are familiar with relevant laws and ensure they do not engage in practices prohibited by such laws or delegate to others activities prohibited by those laws.

2 Midwives practise in accordance with laws relevant to the midwife’s area of practice.

3 Midwives witnessing the unlawful conduct of colleagues and other co-workers, whether in midwifery practice, management, education or research, have both a responsibility and an obligation to report such conduct to an appropriate authority and take other action as necessary to safeguard people and the public interest.

6 Midwives who are employees support the responsible use of the resources of their employing organisations.

4 Midwives respect the dignity, culture, values and beliefs of each woman and her infant(s) in their care and the woman’s partner and family, and of colleagues.

5 Midwives treat personal information obtained in a professional capacity as private and confidential.

Conduct statement 5

Midwives treat personal information obtained in a professional capacity as private and confidential

Explanation

The treatment of personal information should be considered in conjunction with the Guidelines to the National Privacy Principles 2001, which support the Privacy Act 1988 (Cwth). Many jurisdictions also have legislation and policies relating to privacy and confidentiality of personal health information including midwifery care records.

1 Midwives have ethical and legal obligations to treat personal information obtained in a professional capacity as confidential. Midwives protect the privacy of each woman, her infant(s) and family by treating the information gained in the relationship as confidential, restricting its use to professional purposes only.

6 Midwives provide impartial, honest and accurate information in relation to midwifery care and health care products.

Conduct statement 6

Midwives provide impartial, honest and accurate information in relation to midwifery care and health care products

Explanation

1 When midwives provide advice about any care or product, they fully explain the advantages and disadvantages of alternative products or care so individuals can make informed choices. Midwives refrain from engaging in exploitation, misinformation or misrepresentation with regard to health care products and midwifery care.

2 Midwives accurately represent the nature of the midwifery care they intend to provide.

3 Where specific care or a specific product is advised, midwives ensure their advice is based on adequate knowledge and not on commercial or other forms of gain. Midwives refrain from the deceptive endorsement of services or products.

Midwives practise within a woman-centred framework

7 Midwives focus on a woman’s health needs, her expectations and aspirations, supporting the informed decision making of each woman.

Conduct statement 7

Midwives focus on a woman’s health needs, her expectations and aspirations, supporting the informed decision making of each woman

Explanation

1 Midwives ensure the mother and her infant(s) are the primary focus of midwifery care.

2 Midwives support the health and wellbeing of each woman and her infant(s), promoting and preserving practices that contribute to the woman’s self-confidence and the wellbeing of the woman and her infant(s).

4 Midwives support informed decision making by advising the woman and, where the woman wishes, her partner, family, friends or health interpreter, of the nature and purpose of the midwifery care, and assist the woman to make informed decisions about that care.

6 Midwives advocate for the protection of the rights of each woman, her infant(s), partner, family and community in relation to midwifery care.

8 Midwives promote and preserve the trust and privilege inherent in the relationship between midwives and each woman and her infant(s).

Conduct statement 8

Midwives promote and preserve the trust and privilege inherent in the relationship between midwives and each women and her infant(s)

Explanation

1 Midwives promote and preserve the trust inherent in the woman-midwife partnership.

2 An inherent power imbalance exists within the relationship between each woman and midwives that may make the woman and her infant(s) in their care vulnerable and open to exploitation. Midwives actively preserve the dignity of people through practised kindness and by recognising the potential vulnerability and powerlessness of each woman being cared for by midwives. The power relativities between a woman and a midwife can be significant, particularly where the woman has limited knowledge, experiences fear or pain, needs assistance with personal care, or experiences an unfamiliar loss of self-determination. This vulnerability creates a power differential in the relationship between midwives and each woman in their care that must be recognised and managed.

9 Midwives maintain and build on the community’s trust and confidence in the midwifery profession.

Conduct statement 9

Midwives maintain and build on the community’s trust and confidence in the midwifery profession

Explanation

1 The conduct of midwives maintains and builds public trust and confidence in the profession at all times.

2 The unlawful and unethical actions of midwives in their personal lives risk adversely affecting both their own and the profession’s good reputation and standing in the eyes of the public. If the good standing of either individual midwives or the profession were to diminish, this might jeopardise the inherent trust between the midwifery profession and women, as well as the community more generally, necessary for effective relationships and the effective delivery of midwifery care.

3 Midwives consider the ethical interests of the midwifery profession when exercising their right to freedom of speech and participating in public, political and academic debate, including publication.

Midwives practise midwifery reflectively and ethically

10 Midwives practise midwifery reflectively and ethically.

Conduct statement 10                  

Midwives practise midwifery reflectively and ethically

Explanation

1 Midwives practise midwifery reflectively and ethically, practising in accordance with the Code of ethics for midwives in Australia, in order to learn from experience and contribute to personal

2 Midwives develop and maintain appropriate and current midwifery advice, support and care for each woman in their care and her infant(s) and family.

3 Midwives evaluate their conduct and competency according to the standards of the midwifery profession.

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Code of ethics for midwives

1 Midwives value quality midwifery care for each woman and her infant(s).

Value statement 1

Midwives value quality midwifery care for each woman and her infant(s)

Explanation

At the heart of valuing quality midwifery care is valuing each woman, the process of childbirth, the woman- midwife partnership, and the mother-baby relationship. This involves midwives assisting each woman during pregnancy, birth and the early postnatal period, providing support, advice and care according to individual needs. The woman-midwife partnership focuses on the health and midwifery needs of the woman, her infant(s) and her partner and family. Midwives have a responsibility not to interfere with the normal process of pregnancy and childbirth unless it is necessary for the safety of the women and infant(s). Quality midwifery care also necessitates midwives being accountable for the standard of care they provide; helping to raise the standard; and taking action when they consider, on reasonable grounds, the standard to be unacceptable. This includes a responsibility to question and report unethical behaviour or treatment.

2 Midwives value respect and kindness for self and others.

3 Midwives value the diversity of people.

4 Midwives value access to quality midwifery care for each woman and her infant(s).

5 Midwives value informed decision making.

Value statement 5

Midwives value informed decision making

Explanation

Midwives value people’s interests in making free and informed decisions. This includes each woman having the opportunity to verify the meaning and implication of information being given to her when making decisions about her maternity care and childbirth experience. Midwives also recognise that making decisions is sometimes constrained by circumstances beyond individual control and that there may be circumstances where informed decision making cannot always be fully realised

6 Midwives value a culture of safety in midwifery care.

Value statement 6

Midwives value a culture of safety in midwifery care

Explanation

Valuing a culture of safety involves midwives actively engaging in the development of shared knowledge and understanding of the importance of safety – physical, emotional, social and spiritual – as a crucial component of contemporary midwifery care. Midwives who value a culture of safety support reasonable measures, processes and reporting systems designed to reduce the incidence and impact of preventable adverse events in the provision of midwifery care. They also support the open disclosure to women of any adverse events affecting them or their infants during the course of their care

7 Midwives value ethical management of information.

Value statement 7

Midwives value ethical management of information

Explanation

The generation and management of information (including midwifery care records and other documents) are performed with professionalism and integrity. This requires the information being recorded to be accurate, non-judgemental and relevant to the midwifery care of the woman and her infant(s). All midwifery documentation is a record that cannot be changed or altered other than by the addition of further information. A notation in a record or a document used for midwifery care communication can have a powerful positive or negative impact on the quality of care received by a woman and her infant(s). These effects can be long-lasting, either through ensuring the provision of quality care, or through enshrining stigma, stereotyping and judgement in maternity care decision making and maternity care provision experienced by a woman and her infant(s).

The ethical management of information involves respecting people’s privacy and confidentiality without compromising health or safety. This applies to all types of data, including clinical and research data, irrespective of the medium in which the information occurs or is stored. Personal information may only be shared with the consent of the individual or with lawful authorisation.

8 Midwives value a socially, economically and ecologically sustainable environment promoting health and wellbeing.

Value statement 8

Midwives value a socially, economically and ecologically sustainable environment, promoting health and wellbeing

Explanation

Midwives value strategies aimed at preventing, minimising and overcoming the harmful effects of economic, social or ecological factors on the health of each woman, her infant(s), family and community. Commitment to a healthy environment involves the conservation and efficient use of resources such as energy, water and fuel, as well as clinical and other materials.

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Addendum 3

Guidelines for advertising regulated health services

6.2 Prohibited advertising under the National Law

Section 133 of the National Law prohibits advertising that:

  • is false, misleading or deceptive or is likely to be so
  • offers a gift, discount or other inducement to attract a user of the health service without stating the terms and conditions of the offer
  • uses testimonials or purported testimonials
  • creates an unreasonable expectation of beneficial treatment, and/or
  • encourages the indiscriminate or unnecessary use of health services.

6.2.1 Misleading or deceptive advertising

Section 133 of the National Law states:

1 A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

a Is false, misleading or deceptive or is likely to be misleading or deceptive

Eg:

– mislead, either directly, or by implication, use of emphasis, comparison, contrast or omission

– only provide partial information which could be misleading

– imply that the regulated health services can be a substitute for public health vaccination or immunisation

– advertise the health benefits of a regulated health service when there is no proof that such benefits can be attained, and/or

– compare different regulated health professions or practitioners, in the same profession or across professions, in a way that may mislead or deceive.

6.2.2 Gifts and discounts

Section 133 of the National Law states:

1 A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

b Offers a gift, discount or other inducement to attract a person to use the service or the business, unless the advertisement also states the terms and conditions of the offer

Advertising may contravene the National Law when it:

– contains price information that is inexact

– contains price information that does not specify any terms and conditions or variables to an advertised price, or that could be considered misleading or deceptive

– states an instalment amount without stating the total cost (which is a condition of the offer), and/or

– does not state the terms and conditions of offers of gifts, discounts or other inducements.

6.2.3 Testimonials

Section 133 of the National Law states:

1 A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

c Uses testimonials or purported testimonials about the service or business

6.2.4 Unreasonable expectation of beneficial treatment

Section 133 of the National Law states:

1 A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

d Creates an unreasonable expectation of beneficial treatment

6.2.5 Encouraging indiscriminate or unnecessary use of health services

Section 133 of the National Law states:

1 A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –

e Directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services

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Addendum 4

Social Media Policy

When using social media, health practitioners should remember that the National Law, their National Board’s code of ethics and professional conduct (the Code of conduct) and the Guidelines for advertising regulated health services (the Advertising guidelines) apply.

Registered health practitioners should only post information that is not in breach of these obligations by:

  • complying with professional obligations
  • complying with confidentiality and privacy obligations (such as by not discussing patients or posting pictures of procedures, case studies, patients, or sensitive material which may enable patients to be identified without having obtained consent in appropriate situations)
  • presenting information in an unbiased, evidence-based context, and
  • not making unsubstantiated claims.

Additional information may be available from professional bodies and/or employers, which aims to support health practitioners’ use of social media. However, the legal, ethical, and professional obligations that registered health practitioners must adhere to are set out in the National Boards’ respective Code of conduct and the Advertising guidelines.

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One Response to Anti-vaccine nurses and midwives 6

  1. GiJoel says:

    Good grief, if you don’t want to take a vaccine you should find a job where it isn’t a requirement.

Leave a Reply to GiJoel Cancel reply