New Zealand Midwifery Law and Ethics

Crimes Act 1961 (Health Professionals)

Defines criminal offences and when health professionals are criminally responsible for actions or omissions.

Midwives' knowledge obligation (Crimes Act)

Must have necessary knowledge and skill before performing acts that may endanger life.

Reasonable standard of care (Crimes Act)

What a reasonable practitioner would do in similar circumstances.

Primary pathway for midwifery concerns

Addressed first through regulatory authorities like the Midwifery Council or HDC.

Police powers under Crimes Act

Can investigate death or significant injury regardless of other ongoing reviews.

Female Genital Mutilation (FGM) definition

Procedures intentionally altering or injuring female genitalia for non-medical reasons.

Legal status of FGM in New Zealand

It is completely illegal.

FGM clinical implications

Causes complications during pregnancy, labour, birth, and postpartum care.

Midwife duty regarding FGM

Provide culturally safe care and protect women and girls from harm.

Injury Prevention Act 2001 goal

Provides no-fault cover, rehabilitation, and compensation for personal injuries.

No-fault compensation system benefit

Replaces the need to sue for most personal injuries.

Midwife role in ACC claims

Recognize covered injuries, document them accurately, and submit claims.

Treatment injury (ACC)

An injury caused by treatment, replacing the term 'medical misadventure'.

Requirement for treatment injury cover

Injury must be caused by treatment, not an underlying condition.

Proof needed for treatment injury

Must be caused by treatment, but no proof of practitioner fault is required.

ACC Maternal Birth Injury Cover start date

October 1st, 2022.

Eligible ACC maternal perineal injuries

Obstetric anal sphincter tears (3rd and 4th degree) and perineal tears.

Eligible ACC maternal internal tears

Tears to the labia, vagina, vulva, clitoris, cervix, rectum, anus, or urethra.

Eligible ACC pelvic floor injuries

Levator avulsion, prolapse, fistulas, hematomas, and uterine inversion.

Eligible ACC skeletal birth injuries

Coccyx fracture/dislocation, pubic ramus fracture, and symphysis pubis ligament tears.

Excluded from maternal birth injury cover

Births before Oct 1 2022, pregnancy illnesses, and baby injuries.

Diagnosis requirement for ACC birth injury

Claims must be based on a diagnosed injury, not just symptoms.

Midwife scope for ACC45 forms

Can diagnose and lodge claims within their scope of practice.

ACC45 Work Capacity section restriction

Can only be completed by a doctor or nurse practitioner.

NZ Bill of Rights Act (BORA) 1990

Protects democratic, civil, and individual rights of New Zealand citizens.

BORA Section 10

Right not to be subjected to medical or scientific experimentation without consent.

BORA Section 11

Right to refuse to undergo medical treatment.

Human Rights Act 1993 function

Makes discrimination unlawful based on sex, pregnancy, disability, ethnicity, and age.

Human Rights Amendment Act 2001

Makes government agencies and public bodies accountable for discrimination.

HDC Act 1994 catalyst

The Cartwright inquiry, showing health professionals could not self-regulate.

HDC Act 1994 creations

Creates the Health and Disability Commissioner and the Code of Rights.

Code of Rights: Rights 1 to 3

Respect, freedom from discrimination/coercion, and dignity/independence.

Code of Rights: Rights 4 to 7

Appropriate standard, effective communication, fully informed, and informed consent.

Code of Rights: Rights 8 to 10

Support person, teaching/research consent, and right to complain.

Patient advocacy service

First step for consumers addressing concerns regarding healthcare.

HDC investigation purpose

Determines whether a healthcare provider breached the Code of Rights.

HDC Commissioner outcomes

Can require apologies, education, competency reviews, or disciplinary tribunal charges.