On a sad day in which we discover that a Melbourne woman is suffering from SSPE – an always-fatal condition which is caused by contracting a measles infection years earlier – we bring you one of the worst cases of an anti-vaccination, anti-science nurse-midwife we have seen.
Publicly available image courtesy Facebook.
Leanne Chapman is a registered nurse and registered midwife based in Mildura, in Victoria:
Chapman’s business is called Shifrah Women’s Health:
Astonishingly, Chapman is highly qualified, which makes her dangerous misinformation just that much worse; from her Blogspot:
Chapman’s Facebook page, Shifrah Women’s Health, is so packed with anti-vaccine and other dangerous misinformation that we could only include the 2016 posts made by the page. There is just too much misinformation to go back through 2015 and beyond. This is extraordinary.
For example, on December 21 2015 Chapman linked to the disgraced Australian Vaccination-skeptics Network, an anti-vaccination organisation with a public health warning against its name. We couldn’t even get through December 2015 without taking one dozen screenshots of anti-vaccination misinformation:
The number of Chapman’s apparent breaches of the Nursing and Midwifery Board of Australia competency standards, codes of conduct, advertising guidelines, and social media policy is overwhelming. See addenda at the end of this post.
Only last night, April 17 2016, Chapman went on an anti-vaccination posting spree. This is the German homeopath’s survey:
On April 17 2016, Chapman posted lies about the Gardasil vaccine:
On April 17 2016, Chapman posted lies about vaccines having killed babies in a vaccine trial:
On April 17 2016, Chapman posted misinformation from US anti-vaccination activist, Toni Bark:
On April 17 2016, Chapman again posted anti-vaccination misinformation derived from the German homeopath’s survey:
On April 13 2016, Chapman again shared misinformation by Toni Bark, sourced from the rabid anti-vaccination Facebook group, Vaccine Resistance Movement:
On March 29 2016, Chapman promoted Andrew Wakefield’s anti-vaccine documentary, Vaxxed:
On March 22 2016, Chapman posted this meme which features the claims of deranged ex-Queensland police officer, anti-vaccinationist, anti-Semite, and white supremacist, Chris Savage:
On March 19 2016, Chapman posted this outrageous conspiracy theory which even the AVN won’t touch; the conspiracy alleges that there is a campaign to spray aerosol vaccine chemtrails over the population:
On March 15 2016, Chapman shared this post from the rabid anti-vaccination Facebook page, VINE:
On March 15 2016, Chapman posted this anti-vaccination conspiracy theory meme:
On March 9 2016, Chapman posted this anti-Gardasil article:
On March 7 2016, Chapman shared this video from the No Jab No Pay anti-vaccination protest page; the video features anti-vaccination activist Tanya Hammond:
On March 3 2016, Chapman posted this article which claims that philanthropist Bill Gates is guilty of vaccine crimes:
On February 25 2016, Chapman posted this zika virus conspiracy theory which alleges that the maternal whooping cough booster is responsible for the outbreak:
On February 25 2016, Chapman posted this anti-vaccine trope regarding the SV-40 virus which contaminated the polio vaccine, over fifty years ago. No one has ever been found to have developed cancer from this long-acknowledged contamination:
On February 24 2016, Chapman shared this breathtakingly bizarre conspiratorial article which alleges a concerted campaign, by Big Pharma, to systematically murder alternative health practitioners:
On February 22 2016, Chapman shared this anti-vaccine meme against the polio vaccine:
On February 19 2016, Chapman shared this outrageous anti-vaccination meme labeling vaccines as poison:
On February 16 2016, Chapman posted this deranged article from Truthkings, by Sherri Tenpenny, arguing against vaccination in pregnancy:
On February 12 2016, Chapman posted this zika virus conspiracy theory:
On February 11 2016, Chapman shared this zika virus post from anti-vaccination multi-conspiracy theorist John Rappoport:
On February 9 2016, Chapman posted this anti-Gardasil article citing the crank organisation, the American College of Pediatricians. Even the ACP has backpedaled on the claims made in these articles:
On February 2 2016, Chapman shared this offensive zika virus conspiracy theory which alleges vaccines are the cause of microencephaly. The young girls featured in the image did not have zika virus. Their picture has been misused without the permission of their mother, Gwen Hartley:
On January 12 2016, Chapman shared this anti-vaccination chiropractic article which falsely claims that vaccines are being shunned in France; our friend Skeptical Raptor debunked this article:
On January 11 2016, Chapman shared hits Mercola article which argues against vaccination in pregnancy:
On January 7 2016, Chapman posted this article which argues against the life-saving Vitamin K shot:
On January 5 2016, Chapman posted these lies about philanthropist Bill Gates’ polio immunisation efforts:
We can see how far back Chapman’s dissemination of anti-vaccination lies goes; this is from November 1 2013, on the posts to page:
On October 31 2013, Chapman shared this anti-vaccination article, from her profile to her page, regarding vaccine ingredients:
Chapman’s Facebook profile – where Chapman cites her qualifications and business name – is also filled with anti-vaccination misinformation and activism.
On April 7 2016, Chapman shared this anti-vaccination post which was written by the delusional, deregistered enrolled nurse, Louisa Kenzig (Lulu Langford). Kenzig asserts that public immunisation is terrorism:
On March 11 2016, Chapman shared this anti-vaccination petition against the Victorian government’s No Jab No Play laws which link childcare access to immunisation status. Chapman shared this petition several more times on her profile:
On February 15 2016, Chapman also posted this astonishing meme which asserts that several recent pandemics are all part of a conspiracy by Big Pharma and governments:
Anti-vaccination misinformation is not the only dangerous misinformation shared by Chapman on her business page.
On April 14 2016, Chapman shared this anti-fluoridation article from Natural News:
On January 14 2016, Chapman shared this anti-fluoridation article, also from Natural News:
On April 13 2016, Chapman shared this article from Mark Hyman, which argues against anti-depressant medication. Remember that Chapman cites, among her qualifications, that she is a counselor:
On April 12 2016, Chapman posted this article which promotes the non-evidence-based thermography as an alternative to breast-screening:
Back on November 7 2013, Chapman posted – from her profile to her page – an article which argues against breast-screening:
On February 5 2016, Chapman posted this article regarding GMO’s links to tumours in rats, which had already been retracted:
On April 13 2016, Chapman promoted a quote from Janet Fraser, the woman who killed her own baby by practising freebirthing, in 2009:
On October 23 2013, Chapman even posted this Natural News article which denies the Theory of Evolution. Really:
On March 3 2016, Chapman posted this article about chemtrails:
Another common breach we find from alternative health practitioners – practitioners such as chiropractors, who are also registered under AHPRA, the national regulator – is the illegal use of testimonials. This is illegal. The illegal use of testimonials and other illegal advertising is against the law. There are penalties in place for this illegal activity. I don’t know of any cases where penalties have been enforced. Did I mention that testimonials are illegal?
In the following addenda the reader will find the excerpts of commonly breached sections of the Nursing and Midwifery Board of Australia’s competency standards, codes of conduct and ethics, advertising guidelines, and social media policy from which the reader may wish to choose to lodge a complaint. Complaints to the NMBA can be made, here.
Thanks for reading.
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Addendum 1
National competency standards for the midwife (PDF)
Legal and professional practice
Competency 1
Functions in accordance with legislation and common law affecting midwifery practice
Element 1.1
Demonstrates and acts upon knowledge of legislation and common law pertinent to midwifery practice.
Element 1.2
Complies with policies and guidelines that have legal and professional implications for practice.
Element 1.3
Formulates documentation according to legal and professional guidelines.
Element 1.4
Fulfils the duty of care in the course of midwifery practice.
Competency 2
Accepts accountability and responsibility for own actions within midwifery practice.
Element 2.1
Recognises and acts within own knowledge base and scope of practice.
Element 2.2
Identifies unsafe practice and takes appropriate action.
Element 2.3
Consults with, and refers to, another midwife or appropriate health care provider when the needs of the woman and her baby fall outside own scope of practice or competence.
Element 2.4
Delegates, when necessary, activities matching abilities and scope of practice and provides appropriate supervision.
Element 2.5
Assumes responsibility for professional midwifery leadership functions.
Midwifery knowledge and practice
Competency 3
Communicates information to facilitate decision making by the woman.
Element 3.1
Communicates effectively with the woman, her family and friends.
Element 3.2
Provides learning opportunities appropriate to the woman’s needs.
Element 3.3
Plans and evaluates care in partnership with the woman.
Competency 4
Promotes safe and effective midwifery care.
Element 4.1
Applies knowledge, skills and attitudes to enable woman centred care.
Element 4.2
Provides or supports midwifery continuity of care.
Element 4.3
Manages the midwifery care of women and their babies.
Competency 5
Assesses, plans, provides and evaluates safe and effective midwifery care.
Element 5.1
Uses midwifery knowledge and skills to facilitate an optimal experience for the woman.
Element 5.2
Assesses the health and well being of the woman and her baby.
Element 5.3
Plans, provides, and is responsible for, safe and effective midwifery care.
Element 5.4
Protects, promotes and supports breastfeeding.
Element 5.5
Demonstrates the ability to initiate, supply and administer relevant pharmacological substances in a safe and effective manner within relevant state or territory legislation.
Element 5.6
Evaluates the midwifery care provided to the woman and her baby.
Competency 6
Assesses, plans, provides and evaluates safe and effective midwifery care for the woman and/or baby with complex needs.
Element 6.1
Uses a range of midwifery knowledge and skills to provide midwifery care for the woman and/or her baby with complex needs as part of a collaborative team.
Element 6.2
Recognises and responds effectively in emergencies or urgent situations.
Midwifery as primary health care
Competency 7
Advocates to protect the rights of women, families and communities in relation to maternity care.
Element 7.1
Respects and supports women and their families to be self determining in promoting their own health and well–being.
Element 7.2
Acts to ensure that the rights of women receiving maternity care are respected.
Competency 8
Develops effective strategies to implement and support collaborative midwifery practice.
Element 8.1
Demonstrates effective communication with midwives, health care providers and other professionals.
Element 8.2
Establishes, maintains and evaluates professional relationships with other health care providers.
Competency 9
Actively supports midwifery as a public health strategy.
Element 9.1
Advocates for, and promotes midwifery practice, within the context of public health policy.
Element 9.2
Collaborates with, and refers women to, appropriate community agencies and support networks.
Competency 10
Ensures midwifery practice is culturally safe.
Element 10.1
Plans, implements and evaluates strategies for providing culturally safe practice for women, their families and colleagues.
Competency 11
Bases midwifery practice on ethical decision making.
Element 11.1
Practises in accordance with the endorsed Code of Ethics and relevant state/ territories and commonwealth privacy obligations under law.
Competency 12
Identifies personal beliefs and develops these in ways that enhance midwifery practice.
Element 12.1
Addresses the impact of personal beliefs and experiences on the provision of midwifery care.
Element 12.2
Appraises and addresses the impact of power relations on midwifery practice.
Competency 13
Acts to enhance the professional development of self and others.
Element 13.1
Assesses and acts upon own professional development needs.
Element 13.2
Contributes to, and evaluates, the learning experiences and professional development of others.
Competency 14
Uses research to inform midwifery practice.
Element 14.1
Ensures research evidence is incorporated into practice.
Element 14.2
Interprets evidence as a basis to inform practice and decision making.
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Addendum 2
National competency standards for the registered nurse (PDF)
Professional practice
Relates to the professional, legal and ethical responsibilities which require demonstration of a satisfactory knowledge base, accountability for practice, functioning in accordance with legislation affecting nursing and health care, and the protection of individual and group rights.
1 Practises in accordance with legislation affecting nursing practice and health care
1.1 Complies with relevant legislation and common law
1.2 Fulfils the duty of care
1.3 Recognises and responds appropriately to unsafe or unprofessional practice
2 Practises within a professional and ethical nursing framework
2.1 Practises in accordance with the nursing profession’s codes of ethics and conduct
2.2 Integrates organisational policies and guidelines with professional standards
2.3 Practises in a way that acknowledges the dignity, culture, values, beliefs and rights of individuals/groups
2.4 Advocates for individuals/groups and their rights for nursing and health care within organisational and management structures
2.5 Understands and practises within own scope of practice
2.6 Integrates nursing and health care knowledge, skills and attitudes to provide safe and effective nursing care
2.7 Recognises the differences in accountability and responsibility between registered nurses, enrolled nurses and unlicensed care workers
Critical thinking and analysis
Relates to self-appraisal, professional development and the value of evidence and research for practice. Reflecting on practice, feelings and beliefs and the consequences of these for individuals/ groups is an important professional bench- mark.
3 Practises within an evidence-based framework
3.1 Identifies the relevance of research to improving individual/group health outcomes
3.2 Uses best available evidence, nursing expertise and respect for the values and beliefs of individuals/groups in the provision of nursing care
3.3 Demonstrates analytical skills in accessing and evaluating health information and research evidence
3.4 Supports and contributes to nursing and health care research
3.5 Participates in quality improvement activities
4 Participates in ongoing professional development of self and others
4.1 Uses best available evidence, standards and guidelines to evaluate nursing performance:
4.2 Participates in professional development to enhance nursing practice
4.3 Contributes to the professional development of others
4.4 Uses appropriate strategies to manage own responses to the professional work environment
Provision and coordination of care
Relates to the coordination, organisation and provision of nursing care that includes the assessment of individuals/ groups, planning, implementation and evaluation of care.
5 Conducts a comprehensive and systematic nursing assessment
5.1 Uses a relevant evidence-based assessment framework to collect data about the physical socio-cultural and mental health of the individual/group
5.2 Uses a range of assessment techniques to collect relevant and accurate data
5.3 Analyses and interprets assessment data accurately
6 Plans nursing care in consultation with individuals/groups, significant others and the interdisciplinary health care team
6.1 Determines agreed priorities for resolving health needs of individuals/groups:
6.2 Identifies expected and agreed individual/group health outcomes including a time frame for achievement
6.3 Documents a plan of care to achieve expected outcomes
6.4 Plans for continuity of care to achieve expected outcomes
7 Provides comprehensive, safe and effective evidence-based nursing care to achieve identified individual/group health outcomes
7.1 Effectively manages the nursing care of individuals/groups
7.2 Provides nursing care according to the documented care or treatment plan
7.3 Prioritises workload based on the individual/group’s needs, acuity and optimal time for intervention
7.4 Responds effectively to unexpected or rapidly changing situations
7.5 Delegates aspects of care to others according to their competence and scope of practice
7.6 Provides effective and timely direction and supervision to ensure that delegated care is provided safely and accurately
7.7 Educates individuals/groups to promote independence and control over their health
8 Evaluates progress towards expected individual/group health outcomes in consultation with individuals/groups, significant others and interdisciplinary health care team
8.1 Determines progress of individuals/groups toward planned outcomes
8.2 Revises the plan of care and determines further outcomes in accordance with evaluation data
Collaborative and therapeutic practice
Relates to establishing, sustaining and concluding professional relationships with individuals/groups. This also contains those competencies that relate to nurses understanding their contribution to the interdisciplinary health care team.
9 Establishes, maintains and appropriately concludes therapeutic relationships
9.1 Establishes therapeutic relationships that are goal directed and recognises professional boundaries
9.2 Communicates effectively with individuals/groups to facilitate provision of care
9.3 Uses appropriate strategies to promote an individual’s/group’s self-esteem, dignity, integrity and
9.4 Assists and supports individuals/groups to make informed health care decisions
9.5 Facilitates a physical, psychosocial, cultural and spiritual environment that promotes individual/group safety and security
10 Collaborates with the interdisciplinary health care team to provide comprehensive nursing care
10.1 Recognises that the membership and roles of health care teams and service providers will vary depending on an individual’s/group’s needs and health care setting
10.2 Communicates nursing assessments and decisions to the interdisciplinary health care team and other relevant service providers
10.3 Facilitates coordination of care to achieve agreed health outcomes
10.4 Collaborates with the health care team to inform policy and guideline development
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Addendum 3
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 4
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 5
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
Advertising may contravene the National Law when it:
– makes use of time-limited offers which influence a consumer to make decisions under the pressure of time and money rather than about their health care needs.
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Addendum 6
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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8 Responses to Anti-vaccine nurses and midwives 10