What’s the ethical response when a provider learns that a course of action she recommended has caused unintended harm?
Lactation consultants believe (because they teach and tell each other) that breastfeeding is best for every baby. As a result, they have harmed tens of thousands of babies and mothers for whom breastfeeding will never and can never be best. The Royal College of Midwives obliquely acknowledged that harm by reminding midwives that bottle feeding is a valid choice and that women who choose it merit respect and support.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Milli Hill, Amy Brown and Sheena Byrom among others are on Twittter right now engaged in this unethical behavior even as we speak.[/pullquote]
Midwives in general and UK/Australian midwives in particular believe (because they teach and tell each other) that unmedicated vaginal birth, so called normal birth, is best for nearly every mother and baby. As a result they have harmed untold numbers of mothers and babies who have sustained birth injuries, brain damage or even died when complications were ignored in the pursuit of vaginal birth. The Royal College of Midwives obliquely acknowledged that harm by shuttering their Campaign for Normal Birth.
Those are nice first steps, but sadly the RCM did not go far enough. As a result the bullying of mothers continues and many of the rank and file feel free to ignore the admonitions. Medical ethics requires more of providers who issue a recommendation that causes unintended harm than simply stopping the harmful recommendations. Ethics requires acknowledgement of the harm, support of those who have been harmed and reevaluation of the scientific evidence that undergird the harmful recommendation.
Instead, lactivists, like UK/Australian midwives before them have done the opposite.
- They’ve denied the harms.
- They’ve derided the parents of babies who have been harmed and called them liars.
- They’ve impugned the integrity of safety advocates.
- They’ve dismissed the scientific evidence of harm.
- And they’ve invoked their good intentions to absolve themselves of responsibility.
Milli Hill, Amy Brown and Sheena Byrom among others are on Twittter right now engaged in this unethical behavior even as we speak.
Imagine for a moment if the doctors who prescribed DES (diethylstilbestrol) had behaved like Hill, Brown and Bryom.
Diethylstilbestrol (DES) was first synthesized in 1938 and was the first orally active nonsteroidal estrogen that could be used for human therapy. At that time, endocrinology was in its infancy and this discovery was a unique and great advance. Recurrent pregnancy loss was a serious medical problem then as it is now. It was believed the problems were due to a faulty hormonal environment of the fetal-placental unit, rather than primarily to genetic causes, as we have subsequently learned.
The result was unforeseen disaster.
Then, in the late 1960s, eight extraordinarily rare cases of clear cell adenocarcinoma (CCA) of the vagina were diagnosed and treated in women in their teens and early 20s in the Boston area. No such cluster of cases in young patients had ever been seen previously. CCA of the vagina was known to be a cancer that rarely occurred even in older women. In an effort to understand the cause of this cluster, a case-control study was conducted at the Massachusetts General Hospital in 1971 that linked the appearance of these cancers to the patients’ mothers having been treated with DES …
Subsequently, DES use during pregnancy was associated with other adverse health effects in the exposed female offspring, including an increased frequency of anatomic problems in the female genital tract … all of which led to pregnancy complications including premature birth of offspring of the DES-exposed daughters…
How did the medical profession respond?
They acknowledged the harms, indeed they publicized the harms in an effort to inform any woman who might be affected.
They validated the harms that had befallen the affected women. They did not accuse them of lying about the harms; they did not impugn their integrity; they did not ignore the scientific evidence.
They did not invoke their unquestionably good intentions to avoid responsibility.
They reassessed the scientific evidence and the faulty conclusions they had drawn from it.
In contrast, lactivists and many midwives are still in deep denial despite both scientific evidence and testimonials of harm on both social and mainstream media.
Dr. Miriam Stoppard rightly takes them to task over their denial in regard to breastfeeding.
I don’t know which I feel more, anger or relief, at the announcement from the Royal College of Midwives (RCM) that mothers who choose to bottle feed their babies must be respected.
What took them so long to realise their rigid adherence to a policy of pressuring women to breastfeed was cruel and heartless?
Legions of bottle-feeding mothers have been humiliated and made to feel failures, guilt and shame by hard core midwives and health visitors who toed the party line and used “breast is best” as a whip to subjugate new mums.
I couldn’t have said it better myself!
The RCM is now all appeasement. “We know every woman wants the best for her baby and we want to be able to empower our members to support women to be the best they can be and enable them to make decisions that are right for themselves and their babies.”
But what about all those terrified mothers who were bullied and harassed by health care professionals making their lives a misery?
An apology would seem appropriate.
An apology would be nice, but a good first step would be to reprimand the Milli Hills, Amy Browns, and Sheena Byrons for their unethical behavior and publicly tell them to stop.
