Compliance
Chiropractic Cod e of Ethics
T
he OCA is engaging members in a dialogue about issues related to
professionalism and ethics within chiropractic. A review of the College
of Chiropractors of Ontario’s (CCO) Guideline G-009: Code of Ethics may be
relevant in conjunction with that member consultation process.
The stated intent of the Code of
Ethics is “to advise chiropractors of
their obligations to act competently
and ethically in the practice of their
profession.” This is in the context of
the privilege of self-regulation that
the Ontario government granted to
chiropractic in 1991 through the
Chiropractic Act and Regulated Health
Professions Act. As members of a selfregulated health profession, chiropractors
have an obligation to act competently
and ethically. The CCO explains in
the Code of Ethics that maintaining
this commitment to competent and
ethical practice is essential to ensuring
the public’s trust, collaboration with
colleagues and the integrity and dignity
of the profession.
What are Chiropractors’ Ethical
Obligations to Patients?
The ethical obligation chiropractors have
to patients is to practice only within the
limits of their professional and personal
competence. Chiropractors must also
practice with personal integrity while
working to acquire and maintain the
confidence and respect of patients. The
Code of Ethics goes on to outline several
ways in which chiropractors shall operate
in order to “have the well-being of the
patient as their paramount objective”.
These ways include:
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• Providing care that is both appropriate
and necessary,
• Refraining from making guarantees of
cures to patients in any form, and,
• Collaborating with other health care
practitioners so that the patient will
have the benefit of “coordinated team
care”.
The Code of Ethics also speaks to
physical practice surroundings, nondiscrimination, privacy and confidentiality
when outlining ethical obligations to
patients.
What are Chiropractors’ Ethical
Obligations to Professional Colleagues?
The Code of Ethics states that “ethical
chiropractors shall not judge fellow
practitioners, their qualifications or the
procedures they use, except as may be
required in the interests of the health
of patients.” Rather, chiropractors are
expected to work collaboratively with
other practitioners and health care team
members in the advancement of patient
care.
Chiropractors are required to refrain
from taking over a case that has been under
the care of another chiropractor, except
in an emergency, in consultation with the
patient’s previous chiropractor, when the
previous chiropractor has relinquished the
case or when the patient has stated that
they no longer wish to be treated by the
previous chiropractor.
Finally, chiropractors are forbidden
to enter contractual agreements regarding
their professional services which includes
inequitable terms, are not agreeable to all
parties, and/or do not maintain integrity
and high quality care. This should be
considered when entering into associate
agreements with other chiropractors.
What are Chiropractors’ Ethical
Obligations to the Profession?
Encouraging professional and public
education about chiropractic care,
recognizing the necessity of ongoing
research and assisting new members of
the profession are among chiropractors’
ethical obligations to their profession.
Maintaining one level of billing,
except on compassionate grounds or when
professional bodies have negotiated fee
schedules with different payer agencies, is
also a requirement of the Code of Ethics.
Charging different fees while completing
a WSIB Program of Care is an example of
a deviation from standard fees that would
meet the requirements of the Code of
Ethics. Charging different fees to different
patients based on their extended health
coverage is an example of a practice that is
clearly disallowed by the Code of Ethics.