Dignity and Worth of the Person/Pet: Doulas respect the inherent dignity and worth of the person/pet, treating each person/pet in a caring and respectful fashion, mindful of individual/species differences and cultural and ethnic diversity. Doulas seek to educate clients’ on end of life options and promote clients’ autonomy over their own end of life choices. Doulas are cognizant of their dual responsibility to clients and to the family. They seek to resolve conflicts within the family dynamic in a socially responsible manner consistent with the values, ethical principles, and ethical standards.

Consent: Doulas will provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent. Doulas will use clear and understandable language to inform clients of the purpose of the services, limits to services, relevant costs/fees, reasonable alternatives, and clients’ right to refuse or withdraw consent at any time. Doulas will provide clients with an opportunity to ask questions. Doulas will not engage in physical contact with clients, even with the intention to comfort, without their consent (such as hugging, holding). Consent, once established verbally and contractually, can be withdrawn by the client at any time verbally with the doulas respecting those boundaries at the immediate time of occurrence. 

Integrity: Doulas behave in a trustworthy manner. Doulas are continually aware of the mission, values, ethical principles, and ethical standards of EOL care and practice in a manner consistent with them. Doulas will take measures to care for themselves professionally and personally so they can continue to care for others. Doulas act honestly and responsibly and promote ethical practices and conduct themselves ethically.

Confidentiality: Doulas will protect the confidentiality of clients’ written and electronic records and other sensitive information. Doulas will take reasonable steps to ensure that clients’ records are stored in a fireproof safe in a secure location and that clients’ records are not available to others who are not authorized to have access. Douals will protect the confidentiality of all information obtained in the course of professional service. 

Importance of Human/Pet Relationships: Doulas recognize the central importance of human relationships and pet relationships. Doulas understand that relationships between and among people are an important vehicle for change while the relationships between people and pets are also equally important. Doulas engage people as partners in the EOL process to alleviate fear of death. Doulas seek to educate people in a purposeful effort to promote and enhance the well-being of pets at EOL while also assisting individuals, families, social groups, organizations, and communities to accept and understand the same.

Competence: Doulas practice within their areas of competence and develop and enhance their professional expertise. Doulas continually strive to increase their professional knowledge and skills and to apply them in practice. Doulas will consistently engage with new materials and information in order to keep current on best practices and for re-accreditation purposes.

Harassment: Doulas will not use derogatory language in their written, verbal, or electronic communications to or about clients. Doulas will use accurate and respectful language in all communications to and about clients. Doulas will not sexually harass clients. Sexual harassment includes sexual advances; sexual solicitation; requests for sexual favors; and other verbal, written, electronic, or physical contact of a sexual nature. Doulas will under no circumstances engage in sexual activities, inappropriate sexual communications through the use of technology or in person, or sexual contact with current clients, whether such contact is consensual or forced. Doulas will not engage in sexual activities or sexual contact with clients’ relatives or other individuals with whom clients maintain a close personal relationship. Sexual activity or sexual contact with clients’ relatives or other individuals with whom clients maintain a personal relationship has the potential to make it difficult for the doula and client to maintain appropriate professional boundaries. Doulas—not their clients, their clients’ relatives, or other individuals with whom the client maintains a personal relationship—assume the full burden for setting clear, appropriate, and culturally sensitive boundaries.

Payment for Services: When setting fees, doulas will ensure that the fees are fair, reasonable, and commensurate with the services performed. Considerations should be given to clients’ ability to pay, cost of living, etc. Doulas can accept goods or services from clients as payment for professional services. Doulas can participate in bartering when: (1) it can be demonstrated that such arrangements are an accepted practice in the local community, or (2) it is considered to be essential for the provision of services, or (3) negotiated without coercion, but always (4) entered into at the client’s initiative and with the client’s informed consent. Doulas who accept goods or services from clients as payment for professional services assume the full burden of demonstrating that this arrangement will not be detrimental to the client or the professional relationship.

Termination of Services and Referrals: Doulas will refer clients to other professionals when the other professionals’ specialized knowledge or expertise is needed to serve clients fully or when the doula and/or client believe that they are not a good fit and that other services are required. Doulas who refer clients to other professionals should take appropriate steps to facilitate an orderly transfer of responsibility. Doulas who refer clients to other professionals should disclose, with clients’ consent, all pertinent information to the new service providers.

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