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Chiropractic professional ethics

January 01, 1970

Various organizations of practicing chiropractors have outlined formal codes of professional ethics. Actual practice has revealed a wide range of behaviors which may or may not conform to these standards.

Official positions edit

The American Chiropractic Association (ACA) has a "Code of Ethics"[1] "based upon the acknowledgement that the social contract dictates the profession’s responsibilities to the patient, the public, and the profession; and upholds the fundamental principle that the paramount purpose of the chiropractic doctor's professional services shall be to benefit the patient." The smaller International Chiropractor's Association (ICA) also has a detailed set of professional canons.[2]

Reports of actual practice edit

Various situations have occurred in which the ethics of chiropractors and chiropractic organizations have been called into question.

A 2008 commentary proposed that the chiropractic profession actively regulate itself to combat abuse, fraud, and quackery, which are more prevalent in chiropractic than in other health care professions, violating the social contract between patients and physicians.[3]

Gleberzon et al. identify "deliberate fraud" as a notably harmful element of the chiropractic profession, finding that dubious practice techniques can translate into "outlandish billing and utilization rates".[4] Those at the "fringe of ethical behavior" present the profession with a challenge, they believe, and must be weeded out.[4]

A study of California disciplinary statistics during 1997–2000 reported 4.5 disciplinary actions per 1000 chiropractors per year, compared to 2.27 for medical doctors, and the incident rate for fraud was nine times greater among chiropractors (1.99 per 1000 chiropractors per year) than among medical doctors (0.20).[5] According to a 2006 Gallup poll of U.S. adults, when asked how they would "rate the honesty and ethical standards of people in these different fields", chiropractic compared unfavorably with mainstream medicine. When chiropractic was rated, it "rated dead last amongst healthcare professions". While 84% of respondents considered nurses' ethics "very high" or "high," only 36% felt that way about chiropractors. Other healthcare professions ranged from 38% for psychiatrists, to 62% for dentists, 69% for medical doctors, 71% for veterinarians, and 73% for druggists or pharmacists.[3][6][7][8] Similar results were found in the 2003 Gallup Poll.[9]

In 2001, the largest chiropractic associations in the U.S. and Canada were reported to have distributed patient brochures which contained unsubstantiated claims.[10] Chiropractors, especially in America, have a reputation for unnecessarily treating patients. In many circumstances the focus seems to be put on economics instead of health care.[11][12] Sustained chiropractic care is promoted as a preventative tool, but unnecessary manipulation could possibly present a risk to patients.[13] Some chiropractors are concerned by the routine unjustified claims chiropractors have made.[13] A 2010 analysis of chiropractic websites found the majority of chiropractors and their associations made claims of effectiveness not supported by scientific evidence, while 28% of chiropractic websites advocate lower back pain care, which has some sound evidence.[14]

Although in the vast majority of US States chiropractors are considered physicians pursuant to statute[citation needed] (exceptions are inter alia, New York and California). The Joint Commission recognizes chiropractors as physicians as well.[15] In some jurisdictions, like New Zealand, chiropractors appeared to have used the title 'doctor' in a New Zealand yellow pages telephone directory in a way that implied they are registered medical practitioners, when no evidence was presented it was true.[16] In New Zealand, chiropractors are allowed to use the title 'doctor' when it is qualified to show that the title refers to their chiropractic role. A representative from the NZ Chiropractic Board states that entries in the yellow pages under the heading of 'Chiropractors' fulfills this obligation when suitably qualified.[17] If a chiropractor is not a registered medical practitioner, then the misuse of the title 'doctor' while working in healthcare will not comply with the Health Practitioners Competence Assurance Act 2003.[16]

UK chiropractic organizations and their members make numerous claims which are not supported by scientific evidence. Many chiropractors adhere to ideas which are against science and most seemingly violate important principles of ethical behaviour on a regular basis. The advice chiropractors gave to their patients is often misleading and dangerous.[18] In 2009, a backlash to the libel suit filed by the British Chiropractic Association (BCA) against Simon Singh, has inspired the filing of formal complaints of false advertising against more than 500 individual chiropractors within one 24-hour period,[19][20] prompting the McTimoney Chiropractic Association to write to its members advising them to remove leaflets that make claims about whiplash and colic from their practice, to be wary of new patients and telephone inquiries, and telling their members: "If you have a website, take it down NOW." and "Finally, we strongly suggest you do NOT discuss this with others, especially patients."[19] An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression, which is protected by the European Convention on Human Rights.[21] The libel case ended with the BCA withdrawing its suit in 2010.[22][23]

Tenets edit

  • .

See also edit

References edit

  1. ^ Staff. . American Chiropractic Association. Archived from the original on 2014-02-22. Retrieved 2014-02-09.
  2. ^ Staff. . International Chiropractor's Association. Archived from the original on 2014-04-05.
  3. ^ a b Murphy, DR; Schneider, MJ; Seaman, DR; Perle, SM; Nelson, CF (Aug 2008). "How can chiropractic become a respected mainstream profession? The example of podiatry". Chiropractic & Osteopathy. 16: 10. doi:10.1186/1746-1340-16-10. PMC 2538524. PMID 18759966.
  4. ^ a b Gleberzon, Brian J.; Cooperstein, Robert; Perle, Stephen M. (2005). "Can chiropractic survive its chimerical nature?". Journal of the Canadian Chiropractic Association. 49 (2): 69–73. PMC 1840015. PMID 17549192.
  5. ^ Foreman SM, Stahl MJ (September 2004). "Chiropractors disciplined by a state chiropractic board and a comparison with disciplined medical physicians". J Manipulative Physiol Ther. 27 (7): 472–7. doi:10.1016/j.jmpt.2004.06.006. PMID 15389179.
  6. ^ "Gallup Poll: Americans have low opinion of chiropractors' honesty and ethics". Dynamic Chiropractic. 25 (3). 29 January 2007.
  7. ^ "USA TODAY/Gallup poll". USA Today. 11 December 2006.
  8. ^ Inc., Gallup (14 December 2006). "Honesty/Ethics in Professions". {{cite web}}: |last= has generic name (help)
  9. ^ "Public Rates Nursing as Most Honest and Ethical Profession." Gallup Poll, 2003
  10. ^ Grod JP, Sikorski D, Keating JC (October 2001). "Unsubstantiated claims in patient brochures from the largest state, provincial, and national chiropractic associations and research agencies". J Manipulative Physiol Ther. 24 (8): 514–9. doi:10.1067/mmt.2001.118205. PMID 11677551.
  11. ^ Singh S, Ernst E (2008). "The truth about chiropractic therapy". Trick or Treatment: The Undeniable Facts about Alternative Medicine. W.W. Norton. pp. 145–90. ISBN 978-0-393-06661-6.
  12. ^ Samsonov, Mike. "Chiropractic Therapy As a Method of Treatment".
  13. ^ a b Ernst E (2008). "Chiropractic: a critical evaluation". J Pain Symptom Manage. 35 (5): 544–62. doi:10.1016/j.jpainsymman.2007.07.004. PMID 18280103.
  14. ^ Ernst, E; Gilbey, A (2010). "Chiropractic claims in the English-speaking world". The New Zealand Medical Journal. 123 (1312): 36–44. PMID 20389316.
  15. ^ . Joint Commission Perspectives. Archived from the original on 2014-01-04. Retrieved 2014-04-05.
  16. ^ a b Gilbey A (July 2008). "Use of inappropriate titles by New Zealand practitioners of acupuncture, chiropractic, and osteopathy". N. Z. Med. J. 121 (1278): 15–20. PMID 18670471.
  17. ^ Bale K (August 2008). "Chiropractic Board New Zealand response to "Dr Who?" editorial". N. Z. Med. J. 121 (1280): 78–9. PMID 18791634.
  18. ^ Ernst E (July 2009). "UK chiropractic: regulated but unruly". J Health Serv Res Policy. 14 (3): 186–7. doi:10.1258/jhsrp.2009.008183. PMID 19541879. S2CID 43404682.
  19. ^ a b Lucas Laursen. "The Great Beyond: Chiropractic group advises members to 'withdraw from the battleground'". Nature.com. Retrieved 20 June 2009.
  20. ^ Lucas Laursen. "The Great Beyond: Complaints converge on chiropractors". Nature.com. Retrieved 20 June 2009.
  21. ^ "Unjust burdens of proof". Nature. 459 (7248): 751. June 2009. Bibcode:2009Natur.459Q.751.. doi:10.1038/459751a. PMID 19516290.
  22. ^ Pallab Ghosh (2010-04-15). "Case dropped against Simon Singh". BBC News.
  23. ^ Mark Henderson (2010-04-16). "Science writer Simon Singh wins bitter libel battle". London: Times Online.

External links edit

  • Institute for Chiropractic Ethics

January 01, 1970
chiropractic, professional, ethics, various, organizations, practicing, chiropractors, have, outlined, formal, codes, professional, ethics, actual, practice, revealed, wide, range, behaviors, which, conform, these, standards, contents, official, positions, rep. Various organizations of practicing chiropractors have outlined formal codes of professional ethics Actual practice has revealed a wide range of behaviors which may or may not conform to these standards Contents 1 Official positions 2 Reports of actual practice 3 Tenets 4 See also 5 References 6 External linksOfficial positions editThe American Chiropractic Association ACA has a Code of Ethics 1 based upon the acknowledgement that the social contract dictates the profession s responsibilities to the patient the public and the profession and upholds the fundamental principle that the paramount purpose of the chiropractic doctor s professional services shall be to benefit the patient The smaller International Chiropractor s Association ICA also has a detailed set of professional canons 2 Reports of actual practice editVarious situations have occurred in which the ethics of chiropractors and chiropractic organizations have been called into question A 2008 commentary proposed that the chiropractic profession actively regulate itself to combat abuse fraud and quackery which are more prevalent in chiropractic than in other health care professions violating the social contract between patients and physicians 3 Gleberzon et al identify deliberate fraud as a notably harmful element of the chiropractic profession finding that dubious practice techniques can translate into outlandish billing and utilization rates 4 Those at the fringe of ethical behavior present the profession with a challenge they believe and must be weeded out 4 A study of California disciplinary statistics during 1997 2000 reported 4 5 disciplinary actions per 1000 chiropractors per year compared to 2 27 for medical doctors and the incident rate for fraud was nine times greater among chiropractors 1 99 per 1000 chiropractors per year than among medical doctors 0 20 5 According to a 2006 Gallup poll of U S adults when asked how they would rate the honesty and ethical standards of people in these different fields chiropractic compared unfavorably with mainstream medicine When chiropractic was rated it rated dead last amongst healthcare professions While 84 of respondents considered nurses ethics very high or high only 36 felt that way about chiropractors Other healthcare professions ranged from 38 for psychiatrists to 62 for dentists 69 for medical doctors 71 for veterinarians and 73 for druggists or pharmacists 3 6 7 8 Similar results were found in the 2003 Gallup Poll 9 In 2001 the largest chiropractic associations in the U S and Canada were reported to have distributed patient brochures which contained unsubstantiated claims 10 Chiropractors especially in America have a reputation for unnecessarily treating patients In many circumstances the focus seems to be put on economics instead of health care 11 12 Sustained chiropractic care is promoted as a preventative tool but unnecessary manipulation could possibly present a risk to patients 13 Some chiropractors are concerned by the routine unjustified claims chiropractors have made 13 A 2010 analysis of chiropractic websites found the majority of chiropractors and their associations made claims of effectiveness not supported by scientific evidence while 28 of chiropractic websites advocate lower back pain care which has some sound evidence 14 Although in the vast majority of US States chiropractors are considered physicians pursuant to statute citation needed exceptions are inter alia New York and California The Joint Commission recognizes chiropractors as physicians as well 15 In some jurisdictions like New Zealand chiropractors appeared to have used the title doctor in a New Zealand yellow pages telephone directory in a way that implied they are registered medical practitioners when no evidence was presented it was true 16 In New Zealand chiropractors are allowed to use the title doctor when it is qualified to show that the title refers to their chiropractic role A representative from the NZ Chiropractic Board states that entries in the yellow pages under the heading of Chiropractors fulfills this obligation when suitably qualified 17 If a chiropractor is not a registered medical practitioner then the misuse of the title doctor while working in healthcare will not comply with the Health Practitioners Competence Assurance Act 2003 16 UK chiropractic organizations and their members make numerous claims which are not supported by scientific evidence Many chiropractors adhere to ideas which are against science and most seemingly violate important principles of ethical behaviour on a regular basis The advice chiropractors gave to their patients is often misleading and dangerous 18 In 2009 a backlash to the libel suit filed by the British Chiropractic Association BCA against Simon Singh has inspired the filing of formal complaints of false advertising against more than 500 individual chiropractors within one 24 hour period 19 20 prompting the McTimoney Chiropractic Association to write to its members advising them to remove leaflets that make claims about whiplash and colic from their practice to be wary of new patients and telephone inquiries and telling their members If you have a website take it down NOW and Finally we strongly suggest you do NOT discuss this with others especially patients 19 An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression which is protected by the European Convention on Human Rights 21 The libel case ended with the BCA withdrawing its suit in 2010 22 23 Tenets editACA s Page on Ethical Practice ICA Ethics See also editChiropracticReferences edit Staff Code of Ethics American Chiropractic Association Archived from the original on 2014 02 22 Retrieved 2014 02 09 Staff ICA code of Ethics International Chiropractor s Association Archived from the original on 2014 04 05 a b Murphy DR Schneider MJ Seaman DR Perle SM Nelson CF Aug 2008 How can chiropractic become a respected mainstream profession The example of podiatry Chiropractic amp Osteopathy 16 10 doi 10 1186 1746 1340 16 10 PMC 2538524 PMID 18759966 a b Gleberzon Brian J Cooperstein Robert Perle Stephen M 2005 Can chiropractic survive its chimerical nature Journal of the Canadian Chiropractic Association 49 2 69 73 PMC 1840015 PMID 17549192 Foreman SM Stahl MJ September 2004 Chiropractors disciplined by a state chiropractic board and a comparison with disciplined medical physicians J Manipulative Physiol Ther 27 7 472 7 doi 10 1016 j jmpt 2004 06 006 PMID 15389179 Gallup Poll Americans have low opinion of chiropractors honesty and ethics Dynamic Chiropractic 25 3 29 January 2007 USA TODAY Gallup poll USA Today 11 December 2006 Inc Gallup 14 December 2006 Honesty Ethics in Professions a href Template Cite web html title Template Cite web cite web a last has generic name help Public Rates Nursing as Most Honest and Ethical Profession Gallup Poll 2003 Grod JP Sikorski D Keating JC October 2001 Unsubstantiated claims in patient brochures from the largest state provincial and national chiropractic associations and research agencies J Manipulative Physiol Ther 24 8 514 9 doi 10 1067 mmt 2001 118205 PMID 11677551 Singh S Ernst E 2008 The truth about chiropractic therapy Trick or Treatment The Undeniable Facts about Alternative Medicine W W Norton pp 145 90 ISBN 978 0 393 06661 6 Samsonov Mike Chiropractic Therapy As a Method of Treatment a b Ernst E 2008 Chiropractic a critical evaluation J Pain Symptom Manage 35 5 544 62 doi 10 1016 j jpainsymman 2007 07 004 PMID 18280103 Ernst E Gilbey A 2010 Chiropractic claims in the English speaking world The New Zealand Medical Journal 123 1312 36 44 PMID 20389316 The Joint Commission Now Recognizes Chiropractors as Physicians Joint Commission Perspectives Archived from the original on 2014 01 04 Retrieved 2014 04 05 a b Gilbey A July 2008 Use of inappropriate titles by New Zealand practitioners of acupuncture chiropractic and osteopathy N Z Med J 121 1278 15 20 PMID 18670471 Bale K August 2008 Chiropractic Board New Zealand response to Dr Who editorial N Z Med J 121 1280 78 9 PMID 18791634 Ernst E July 2009 UK chiropractic regulated but unruly J Health Serv Res Policy 14 3 186 7 doi 10 1258 jhsrp 2009 008183 PMID 19541879 S2CID 43404682 a b Lucas Laursen The Great Beyond Chiropractic group advises members to withdraw from the battleground Nature com Retrieved 20 June 2009 Lucas Laursen The Great Beyond Complaints converge on chiropractors Nature com Retrieved 20 June 2009 Unjust burdens of proof Nature 459 7248 751 June 2009 Bibcode 2009Natur 459Q 751 doi 10 1038 459751a PMID 19516290 Pallab Ghosh 2010 04 15 Case dropped against Simon Singh BBC News Mark Henderson 2010 04 16 Science writer Simon Singh wins bitter libel battle London Times Online External links editInstitute for Chiropractic Ethics ICA Canons of Ethics Retrieved from https en wikipedia org w index php title Chiropractic professional ethics amp oldid 1207805233, wikipedia, wiki, book, books, library,

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