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<chapter num="03" heading="Code of Ethics" title_num="10" subtitle_num="69">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>Abandonment.</text>
        <paragraph num="(a)">
          <text>“Abandonment” means failure to provide or make reasonable arrangements for the continuation of care for a client in need of immediate care or failure to provide reasonable notice to a facility or practice under circumstances that seriously impair the delivery of clinical care to clients.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Abandonment” does not include the declining by a licensed certified midwife of employer-stipulated mandatory overtime.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>“Board” means the Board of Nursing.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Client” means a patient, resident, or recipient of care.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Electronic devices” means, but is not limited to, any of the following:</text>
        <paragraph num="(a)">
          <text>Telephones with recording and picture-taking ability;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Digital cameras or any other device that can record pictures and data;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Facsimile machines, photocopiers, and scanners for copying; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Recording devices.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>“Licensed certified midwife (LCM)” means an individual who has been issued a license by the Board to practice certified midwifery in accordance with COMAR 10.69.01.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Social Media.</text>
        <paragraph num="(a)">
          <text>“Social media” means any form of electronic communication.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Social media” includes but is not limited to communication by use of websites or other electronic applications for social networking, commentary, and blogging through which users create online communities to share information, ideas, personal messages, and other content such as videos.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Ethical Responsibilities.">
    <paragraph num="A.">
      <text>A licensed certified midwife shall:</text>
      <paragraph num="(1)">
        <text>Provide services with respect for human dignity and the uniqueness of a client unrestricted by consideration of social or economic status, religious affiliation, personal attributes, race, sexual orientation, gender identity, or the nature of health problems;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Safeguard a client's right to privacy by maintaining confidentiality of information;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Act to safeguard a client and the public if health care and safety are affected by the incompetent, unethical, or illegal practice of any person;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Promptly report a breach of confidentiality or privacy;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Assume responsibility and accountability for individual clinical judgments and actions;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Maintain competence in licensed certified midwifery;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Exercise informed judgment and use individual competence and qualifications as criteria in seeking consultation, accepting responsibilities, and when delegating; and</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Inform the Board regarding unethical conduct by another licensed certified midwife.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>A licensed certified midwife may not, when acting in the capacity or identity of a licensed certified midwife:</text>
      <paragraph num="(1)">
        <text>Knowingly participate in or condone dishonesty, fraud, deceit, or misrepresentation;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Engage or participate in an action that violates or diminishes the civil or legal rights of a client;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Perform new techniques and procedures without adequate education and practice;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Assume duties and responsibilities in the practice of licensed certified midwifery without adequate preparation or without maintaining competency;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Practice clinically if unfit to perform procedures or make decisions because of physical or mental impairment, including, but not limited to, the effects of prescription drugs;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>If engaged in research, coerce or pressure a subject to participate or continue to participate in the research; or</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Abandon a client.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>A licensed certified midwife may not engage in behavior that dishonors the profession whether or not they are acting in the capacity or identity of a licensed certified midwife, including, but not limited to:</text>
      <paragraph num="(1)">
        <text>Verbal abuse, including use of racial or ethnic slurs, directed toward a coworker, employer, Board staff member, client, or client’s family member;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Physically abusing, threatening, or intimidating a coworker, employer, Board staff member, client, or client’s family member;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Deceiving, defrauding, or stealing from a coworker, employer, client, or client’s family member;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Diverting any medication or providing false or misleading information to an authorized prescriber or a pharmacist to obtain or attempt to obtain any medication;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Knowingly employ another person to practice, engage in, or attempt to practice, or engage in an occupation or profession licensed by the Board if the employee is not licensed to do so in accordance with Health Occupations Article, Title 8, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Performing acts beyond the authorized scope of the level of midwifery practice for which the individual is licensed;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Obtaining or copying any part of a client’s health record for purposes other than:</text>
        <paragraph num="(a)">
          <text>Providing health care to the client;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Conducting quality improvement activities;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Complying with legal requirements such as a subpoena; or</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Allowing a midwifery student to use records for educational purposes if client identification has been redacted or disguised;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(8)">
        <text>Using, possessing, supplying, administering, or attempting to use, possess, supply, or administer prescription drugs or controlled dangerous substances without valid clinical indication;</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Reporting for employment under the influence of alcohol or a controlled dangerous substance or submitting a pre-employment sample that is positive for alcohol or a controlled dangerous substance without having provided evidence of valid prescriptions for all controlled dangerous substances in the sample;</text>
      </paragraph>
      <paragraph num="(10)">
        <text>Reporting for employment under the influence of an illicit drug or submitting a pre-employment sample that is positive for an illicit drug;</text>
      </paragraph>
      <paragraph num="(11)">
        <text>Using the power, influence, or knowledge, inherent in or obtained during the provider-client relationship, for the licensee’s personal gratification or benefit;</text>
      </paragraph>
      <paragraph num="(12)">
        <text>Engaging in unprofessional or immoral conduct;</text>
      </paragraph>
      <paragraph num="(13)">
        <text>Misrepresenting or concealing a material fact in obtaining a license, renewing a license, or reinstating a license; or</text>
      </paragraph>
      <paragraph num="(14)">
        <text>Committing an act of moral turpitude, dishonesty, or corruption when the act directly or indirectly affects the health, welfare, or safety of the citizens of this State, and, if the act constitutes a crime, conviction thereof in a criminal proceeding is not a condition precedent to disciplinary action.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>A licensed certified midwife may not engage in sexual misconduct. Sexual misconduct includes, but is not limited to:</text>
      <paragraph num="(1)">
        <text>Sexual behavior with a client in the context of a professional evaluation, treatment, procedure, or service to the client, regardless of the setting in which the professional service is rendered;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Sexual behavior with a client under the pretext of diagnostic or therapeutic intent or benefit;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Solicitation of a sexual relationship, whether consensual or nonconsensual, with a client;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Sexual advances toward, or the request of sexual favors from, a coworker, student, employer, client, or client’s family member;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Discussion of nontherapeutic sexual matters while treating a client;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Taking photographs of a client for a sexual purpose;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Sexual harassment of a coworker, student, employer, client, or client’s family member;</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Sexual contact with an incompetent or unconscious client;</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Intentionally exposing any of the licensee's sexual body parts; and</text>
      </paragraph>
      <paragraph num="(10)">
        <text>Intentionally exposing any of the client’s sexual body parts for a nontherapeutic purpose.</text>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Electronic devices may not be used to record medical records and take pictures or videos of clients without written client authorization.</text>
    </paragraph>
    <paragraph num="F.">
      <text>A licensed certified midwife:</text>
      <paragraph num="(1)">
        <text>May not make use of electronic devices and social media to transmit or place any client information online; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Shall adhere to the following principles for the use of electronic devices and social media:</text>
        <paragraph num="(a)">
          <text>Every licensed certified midwife has an obligation to understand the nature, benefits, and consequences of the use of electronic devices and participating in social media networking;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Licensed certified midwives are bound to observe ethically prescribed client-provider boundaries online as in any other setting;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Client information shall be maintained in separate encrypted and secured files on personal computers and online;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>A licensed certified midwife has an obligation to report any electronically generated material that could harm a client’s privacy rights; and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>The standards of professionalism are the same when using electronic devices and social media as in any other circumstance.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Penalties.">
    <text>Violation of this chapter may result in the Board taking disciplinary action against a licensed certified midwife pursuant to Health Occupations Article, §8-6D-10, Annotated Code of Maryland.</text>
  </regulation>
  <annotations>
    <annotation type="Authority">Health Occupations Article, §§ 8-101, 8-205, 8-208, 8-508, 8-601, 8-6A-02, 8-6D-01 through 8-6D-15, 8-701, 8-708, and 8-710, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: February 22, 2026 (52:17 Md. R. 875)</annotation>
  </annotations>
</chapter>