Midwifery deserves its own model of ethics. Midwives have usually adopted ethics from other fields, such as medicine. Yet, midwives’ relationships with clients are unlike those between doctors and patients. For one, midwives embrace a model of care that is woman-and-family-centered. Also, midwives typically develop intimate relationships with the mothers we serve and see ourselves as their partners in care. Medical ethics, which are typically abstract and devoid of relationships, are not the best fit for midwifery practice. Midwifery needs a model of ethics that reflects the Midwives Model of Care.
The main principles of bioethics are applicable to midwifery. Beneficence, to benefit others; and nonmaleficence, do no harm, are relevant to all helping-professions. Yet, to practice these, along with justice, diversity, dignity and autonomy, midwives’ use an ethics of caring.
Caring is a feminine value, and it is how women often approach ethics. While landmark research in moral development demonstrates that boys use the concept of justice to make moral decisions, Carol Gilligan found that girls do so by use of caring. It makes sense that midwives would approach ethics similarly. In fact, through an ethics of care, midwives maintain a client’s dignity in ways that contrast dramatically with the field of medicine.
To apply bioethical principles, midwives consider their relationships with others. For example, when a midwife is faced with an ethical dilemma, she considers not only principles of bioethics, but also the effects that ethical decisions have on her client, the client’s family, the midwife’s practice, and her co-workers, workplace and community. The same kind of relational and caring ethics should be applied when working with others, or non-clients, such as other midwives, physicians, apprentices, supervisors, and complementary and alternative care providers.
In considering ethics for midwives, it is important to recognize the caring and relational aspects of the Midwives Model of Care that affect how midwives make ethical decisions. The Midwives Ecological Model of Ethical Thinking (MEMET) illustrates midwives’ unique approach to ethics. With the midwife and client relationship at it’s center, and the support network, practice setting, and other historical and cultural considerations, the MEMET demonstrates the complex and relational influences on midwives’ ethical thinking. This model is introduced in Professional Ethics in Midwifery Practice (Jones & Bartlett, 2010).