editor’s note Editor FEBRUARY 2013, V olUmE 18 N UmBER 1 Maria DiDanieli [email protected] (289) 259-1408 • (888) 599-2228 ext. 247 Maria DiDanieli Publisher Christine Livingstone [email protected] (519) 429-5173 • (888) 599-2228 ext. 239 I wonder why a review of ethics in practice is seen, by many health disciplines, as less important than learning technical or business-related concepts. At a recent conference, I noticed that only about 40, out of hundreds of registrants, attended a class on ethics in practice. In fact, adherence to the ethical principles comprising respect for the individual, welfare of persons and justice should be considered vital in a clinical setting – to your patients, these principles are indis-pensable in achieving optimal outcomes and high-quality, holistic care; for your practice, they represent incident prevention and success through excellence. In his lecture on ethics in chiropractic practice, Steve Savoie DC cited examples of doctors of all stripes neglecting these principles. He spoke of doctors not allow-ing patients time to expand on points within their history; register complaints; ask questions freely; or, God forbid, question any proposed strategy. Some, he said, create barriers to patient autonomy by failing to provide non-coercive, compre-hensive – and comprehensible – informed consent; and failing to include, or toler-ate, discussion of alternatives to the proposed care plan. He related examples of docs compromising the fiduciary relationship by performing procedures that may not be indicated. He warned against tendencies, across health care, not to provide necessary referrals. And he countered these with examples of outcomes achieved when practitioners adher to ethical principles. Not surprisingly, the rewards of do-ing so, to both patients and doctors, were incontestable by his (alarmingly small) audience. Despite DCs’ commitment to, and reputation for, providing compassionate and holistic care, some members of the profession are guilty of infractions of ethical behaviour, as are some MDs and other health-care professionals. I am well aware your profession struggles with this and that you are working hard to prevent it amongst your ranks. Preliminary solutions to this problem may revolve around giving priority to patient outcomes over patient visits. This can involve the following actions: Take the time required with each patient on each visit – for a given patient, this may vary between visits. Let the patient and their family members talk and ask ques-tions – it’s amazing what this might reveal. Understand your patient’s health goals and explain, without coercion, your preferred strategies and why you feel they will work – openly discuss alternatives. Then, without judgment, allow the patient to choose. Remember that informed consent is an ongoing process – continue to en-sure your patient understands what is being done with, and to, them throughout their care. Don’t commit to a service or activity that you do not have time for, or are not adequately equipped, or trained, to provide – be honest and upfront. Refer out, if necessary. Offer, or agree to provide, letters/documents/referrals, and pro-vide them in a timely and professionally relevant manner. Accept when a strategy, no matter how tried and true, may not work for a particular patient – this is not a sign of your technique’s weakness, but of your strength as a clinician. Finally, don’t shun opportunities to hone your knowledge and understanding of ethical concepts and how they can impact your practice. Most importantly, don’t do all of this because it will ensure you’re “covered” and/or enhance your numbers. Do it, as Dr. Savoie so elegantly stated, because it’s the right thing to do. • Bien à vous, Sales Assistant Sandy Mels [email protected] (519) 429-5183 • (888) 599-2228 ext. 219 Media Designer Kelli Kramer Group Publisher Martin McAnulty [email protected] President Mike Fredericks [email protected] Mailing Address P.O. Box 530, 105 Donly Drive South, Simcoe, ON N3Y 4N5 RETURN UNDELIVERABLE CANADIAN ADDRESSES TO CIRCULATION DEPT., P.O. BOX 530, SIMCOE, ON N3Y 4N5 e-mail: [email protected] Canadian Chiropractor is published eight times a year: February, April, May, June, July/August, September, October and December. Published and printed by Annex Publishing & Printing Inc., 105 Donly Drive South, Simcoe, ON N3Y 4N5 Printed in Canada ISSN 1488-6952 Circulation e-mail: [email protected] Tel: (866) 790-6070 ext. 201 Fax: (877) 624-1940 Mail: P.O. Box 530, Simcoe, ON N3Y 4N5 Subscription Rates Canada – 1 Year $24.00 (with GST $25.20, with HST/QST $27.12) (GST -#867172652RT0001) USA – 1 Year $35.00 (US Funds) Best pricing is available online at www.canadianchiropractor.ca Occasionally, Canadian Chiropractor will mail information on behalf of industry-related groups whose products and services we believe may be of interest to you. If you prefer not to receive this information, please contact our circula-tion department in any of the four ways listed above. No part of the editorial content of this publication may be reprinted without the publisher’s written permission. ©2013 Annex Publishing & Printing Inc. All rights reserved. Opinions expressed in this magazine are not necessarily those of the editor or the publisher. No liability is assumed for errors or omissions. All advertising is subject to the publisher’s approval. Such approval does not imply any endorsement of the products or services advertised. Publisher reserves the right to refuse advertising that does not meet the standards of the publication. 6 • CANADiAN CHiROPRACTOR | FEBRUARY 2013 www.canadianchiropractor.ca
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