Free baby formula

For this case study, let’s assume you recently were promoted and you now manage a hospital dental clinic. As part of this job, you hold a seat on the hospitals Institutional Ethics Committee (IEC). In that capacity, review the following case study, and choose one to write about. You will present your case study to the head of the hospitals Institutional Ethics Committee (IEC)

In addition, the third case was an important policy issue that had ethical implications: Should the hospital provide free baby formula? This issue was more complex than it first appeared.

At question was a curious phenomenon. Health professionals were virtually unanimous in the belief that breast milk was best for infants. Evidence was overwhelming that breast milk reduced a baby’s susceptibility to illnesses such as ear infections and stomach flu and played a positive role in many other ways such as mental and hormonal development. Why, then, did so many mothers who gave birth in hospitals choose synthetic baby formula? The reasons were many and varied, including opposition to breast-feeding from family and friends, lack of good information, unsympathetic work settings, and reasons of custom and fashion. Many health professionals believed hospitals undermined breast-feeding by the widespread practice of giving new mothers free formula supplied by formula manufacturers. Research indicated the practice did make a difference. One study at Boston City Hospital, cited in The Wall Street Journal, found that 343 low-income women, who received free formula from the hospital, breast-fed their infants for a median duration of forty-two days, compared with sixty days for those who received no free formula-a difference of 30 percent. The article concluded with the observation that breast-feeding rates were not much higher than they were ten years ago.

At a joint meeting of the IECs of the three local hospitals, this issue of conflict of interest between formula manufacturers that supplied the free formula and the three hospitals was raised. All three hospitals accepted free baby formula. One breastfeeding proponent candidly described her suspicion of the close ties between hospitals and formula companies hoping to promote their product. Discussion of the issue by IEC members at this joint meeting resulted in four main options for dealing with the issue: (1) accept no free formula at all despite its availability; (2) give no free formula to those who breast-feed; (3) charge patients a nominal fee for the free formula, so families considered the cost of formula when making the breast-feeding decision; and (4) continue to issue free formula but also distribute information about the benefits of breast-feeding. The four options were not prioritized.

At Mr. Blackwell’s request, the IEC of Regional Memorial Hospital is to meet to advise him on a morally justifiable course of action relative to the hospital’s free baby formula practice and to offer advice on what to do about Baby Boy-X and Annie O.

Notes:

1) R. E. Cranford and A. E. Doudera, The Emergence of Institutional Ethics Committees, Proceedings of the American Society of Law and Medicine (April, 1983), p. 13.

2) M. Siegler, “Ethics Committees: Decision by Bureaucracy,” Hastings Center Report 16 (June/July, 1986), pp.3,22