Medical informed consent is explaining to the patient the potential side effects of a perfectly performed medical procedure or a properly administered drug.
Chiropractic informed consent is explaining to the practice member the side effects of a properly administerd chiropractic adjustment. Very simply…there are none.
hey joe as you know this is law in CA to tell clients. i’m still waiting on what the state wants to hear, i don’t think they know since there are no guidelines. i tell them that i am putting a force into the body, tho specific and gentle, so there may be some discomfort. i do tell them the consequences of not getting adjusted tho, and this far outweighs the so called “risks”
I wonder how long these boards would continue to make non-sensical and impractical rules if the chiropractors just simply said ,as a group, “we refuse to comply”. I guess “group” is the key word
Perhaps, as a profession, we should have an “informed consensus” as to what constitutes a ‘properly administered chiropractic adjustment’! (has neurological stress been reduced or eliminated and how do we know that?)
Good topic, Joe!
All medical treatments are dedicated to address a particular body part or body system. The traditional method of choices are drugs or surgery.
Unfortunately, ALL properly performed medical treatments are harmful to the body, thus the consent reasonable.
On the other hand, properly preformed chiropractic spinal adjustments are NEVER harmful if preformed properly. It is only IMPROPER chiropractic spinal adjustment that could lead to problems.
The difference is in the perspective.
Is everyone 100% correct with their adjusting 100% of the time? Otherwise, if something does ever go unfavourably, are you not admitting that you’ve done something wrong and are therefore at fault in a court because of negligence? Other than just the straight philosophy answers, i’m interested to get some answers here. I remember hearing Reggie Gold say in his talk “Chemistry of Life” that sometimes removing interference can actually cause pain/symptoms but that the patient will be better off with the interference removed and the body will act in the appropriate manner. It’s been a long time since I heard that talk to forgive me if I’ve misunderstood/don’t remember correctly. May be a sound philosophy but will it stand up in court? In this example, is this just how the body needed to respond to move towards health or was it a bad adjustment?
Scott,
Your question is very good and I am glad you ask. We must, ALL of us, understand the educated component of introducing a safe universal force into someone’s spine. That’s why we were trained for several years and learned many techniques. The “professional” judgement of the chiropractor includes a paramount factor that should ALWAYS be part of the choice making when introducing a force: INTEGRITY!
INTEGRITY is nothing more and nothing less than honoring one’s word. I gave my word, when I received my degree in 1977, to serve humanity to the best of my abilities. I gave my word when I was licensed in 1977 to practice chiropractic for the WELL BEING of the citizens of my state. When I honor MY word, I have integrity. It is to LIVE in a context of wholeness within myself. Hopefully ALL aspects of my life will be dealt with personal integrity.
Then, there is the fact of being human and fallible in dealing with life.
Can I malpractice? By my intent, the answer is NO! Can unintentionally err in the choice of technique and force applied? The answer is YES! That’s why I say I must give INTEGRITY top priority.
The answer to your question is to live the question. There is NO ABSOLUTE security. To minimize the degree of insecurity, I make integrity FIRST in my practice. It means I serve the PRINCIPLES of chiropractic which is the BEST way for me to serve people. I choose to be guided by the philosophy of chiropractic. I practice the objective of chiropractic: LACVS for full expression of the innate intelligence of the body. I understand and know that it is the innate intelligence of the body that “performs” the adjustment by using force introduced into the body from many sources. My job is to introduce ONLY the least amount of force… at the right place… at the right time… for the right reason. Then I am in INTEGRITY. Having said ALL of that, I still have to live with a certain amount of insecurity. It is as simple as that!
Claude, thanks for the excellent response!! Integrity, principles, LACVS. . it then all falls into place , thanks for the reminder!. . and you nailed it. . there is no absolute security. .
What Reggie was describing was not something going wrong but the body responding to something right happening. If you do something wrong then admit it, own up to it. However, no one is going to end up in court because someone claimed their pain got worse. If you are introducing the correct amount of force, at the right time, in the right manner, only positive results can occur. If not, then you have done something wrong.
Found this article interesting. Thanks Joe!
I have noticed a push to make informed consent a standardized process. The reason offered is one of concern for public safety. In the interest of objectivity I try to keep my subjective opinions to myself.
I’m very curious what an informed consent process would look like for a non-therapeutic office.
My understanding is that the delivering of forces into the spine at the right time, place, quantity and quality can result in only a positive. What of the instances where regardless of intent the forces delivered were not so optimal?
I assume it would be prudent to have a discussion of this unlikely even before delivering any forces. Moreover, disclosing the following is what some have been asked to do. How is this done in a non-therapeutic office?
If you answer anything in this post, please answer these two as honestly as possible, Thanks,
4. What are the effects, material risks and the side effects of the proposed plan of care and how do they compare to the alternatives?
5. What are the likely consequences if they do not have the analysis or plan of care proposed?
I know there are some smart people on this blog who can answer this better than I ever could.
Thanks and looking forward to your responses.
Last point: Even if you have never contributed to this blog, please share your answer. Often there are several people with some great insight and hold back. Please don’t! I am looking for open dialogue.
Thank you again. đŸ™‚