CCA- Canadian Chiropractic Association - AppendixB

Clinical Guidelines for Chiropractic Practice in Canada
Code of Ethics


The Canadian Chiropactic Association recognizes the responsibility of delineating the standards of ethical and professional conduct expected of all Canadian chiropractic practitioners.


The Association acknowledges that the provision of health care is a provincial matter and as such, the ethical chiropractor is obliged by law to practice in accordance with the Act, Regulations, and By-laws of the province in which he or she practices.


The ethical foundation of the practice of chiropractic consists of those established moral obligations which ensure the dignity and integrity of the profession and honor its history and tradition.


The ethical chiropractor will accept the moral responsibility to act as his or her own ethicist. He or she will practice professional, with conscience and will observe the Golden Rule "Do unto others as you would have them do unto you."


Conduct in the practice of the profession should be above reproach and will take neither physical, mental, social, nor financial advantage of a patient.


The chiropractor will show concern for human caring, and whenever possible, will share the responsibility of the health care decision making process with a patient.


The profession will be practiced to the best of the chiropractor's ability, and education will be continued to improve clinical competence and thus, assure the confidence and respect of his or her patients.


The dignity of both colleagues and patients will be respected by being truthful, honoring confidences, and acting with compassion.


The chiropractor will, in the public interest, preserve, protect, and communicate the expertise of the profession in legislative, public education, and research matters.


The chiropractor will collaborate with other recognized health care practitioners toward the ideal of teamwork, in which the rights of both the patients and the profession will be respected equally.


Preamble: These principles are intended to aid chiropractors individually and collectively in maintaining a high level of ethical conduct. They are not immutable laws,for the ethical practitioner needs no such laws, but standards by which a chiropractor may determine the propriety of conduct in relationships with patients, colleagues, members of other health care professions, and with the public.

Article I

Duties of a Chiropractor to the Patient

Patient Care

1.The chiropractor will recognize the responsibility to render health service to any persons regardless of race, religion, or political belief.

2.The chiropractor will recognize the limitations of his or her expertise, and when indicated, will recommend to a patient that additional options and services be obtained.

3.The chiropractor will respect a patient's right to accept or decline care, and is not obliged to treat anyone with whom they have not established a doctor-patient relationship; in which, a patient will act reasonably and pay for services rendered, and a chiropractor will provide professionally acceptable care.

4.The right of a patient to select professional health care, separate or complementary to chiropractic care shall be recognized.

5.A patient, having been accepted, should never be abandoned without due regard for a patient's welfare. Sufficient notice of withdrawal should be given to permit the patient to secure another practitioner.

6.A chiropractor should not take charge of a case which is, or recently has been, under the care of another -chiropractor, except in an emergency, or in consultation with the chiropractor in previous attendance, or when the latter has relinquished a case, or the patient has stated they no longer wish to attend the previous chiropractor.

7.The chiropractor should neither exaggerate nor minimize the gravity of a patient's condition. The chiropractor should assure that the patient, or those persons responsible for the patient, has knowledge of the patient's condition so the best interests of the patient may be served.

Article II

Duties of the Chiropractor to the Profession

Personal and Professional Conduct

1.The chiropractor shall expose, without fear or favour, unethical conduct or incompetence, for any reason, on the part of a member of the profession or may assist a patient to report such matters to those in authority within the provincial jurisdiction.

2.The conduct of the chiropractor at all times should merit the respect of the public for members of the profession.

3.The professional reputation of the chiropractor shall be protected by avoiding all situations which could lead to a conflict of interest.

4.Self-discipline for the profession is a privilege to be recognized along with the responsibility to protect that privilege.

Contractual Arrangements

5.A chiropractor shall, when associating in practice with other chiropractors, insist that they maintain the standards enunciated in this Code of Ethics.

6.A contract offered to a colleague will have terms and conditions equitable and agreeable to both parties.

7.No contract shall be entered into with any organization which jeopardizes professional integrity.

8.The chiropractor shall only enter a contract, regarding his or her professional services, which allows fees derived from chiropractic services to be controlled by the chiropractor rendering the service.

Chiropractic Research

10.The chiropractor shall, through recognized scientific channels, communicate to colleagues or appropriate chiropractic institutions of learning, the results of any chiropractic research, in order that those colleagues or institutions may establish an opinion of its merits or veracity before presentation to the public.

11.New technique methods, devices, or appliances that might be applicable to the practice of chiropractic should be shared with colleagues.

12.The chiropractor must demonstrate competence in the use of research or experimental techniques. The patient's informed consent must be given and the patient will not be charged for such procedures.

Consultation and Examination

12.Confidential information derived from a patient, or any other source, may be divulged only with the written permission of the patient, except to safeguard society or when required by law.

13.The chiropractor will recommend only those diagnostic procedures deemed necessary to assist in the care of the patient, and treatment considered essential for the well-being of the patient.

14.Professional responsibility will be recognized in advising the patient of findings and recommendations.

15.No guarantee of a cure, either by statement or implication, will be given, and an estimate only as to the length of time or number of visits required by a given condition will be offered.

16.When a chiropractor is requested to examine another practitioner's patient on behalf of an authorized third party, he or she will advise and in consultation with the treating practitioner, perform the necessary procedures to provide only that information which was requested. The treating practitioner is expected to co-operate with the consulting practitioner or decline the request.

Professional Fees

17.The welfare of the patient shall always be paramount and expectations of remuneration or lack thereof, should not in any way affect the quality of service rendered to the patient.

18.When determining fees to the patient, consideration will be given to the chiropractor's professional service and the patient's ability to pay. Fees will be discussed with the patient when appropriate, and always when proposed fees exceed those customarily charged.

19.When acting on behalf of a third party, the chiropractor's legal responsibility to the third party must be explained to the patient before proceeding with the examination.

20.When requested by the patient, assistance will be given when supplying information required to enable the patient to receive any benefits to which he or she may be entitled.

21.It is not unethical to dispense items providing; it does not create a conflict of interest, they serve the best interests of the patient, clinical value has been demonstrated, and the item is available at a fair market price.

22.No gift should be accepted if there are conditions attached, which may affect the acceptable professional standards of practice.

Addressing the Public

23."A chiropractor, in any mode of communication, should strive to make it clear that his/her comments are personal and not necessarily representative of all chiropractors, unless expressly authorized to comment on behalf of an established chiropractic organization".

24.A level of competence greater than that actually held, according to accepted standards, shall not be indicated.

25.The most worthy and effective advertising is the establishment of a well merited reputation for professional ability.

26.Advertising should have the support of the profession and provide information that will enhance the ability of the public to make informed choices concerning health care.

27.Advertising must maintain the high standards of the profession and protect the public from irresponsible and misleading statements. It must be truthful and verifiable and should not create unjustified expectations or claim definite results.

28.Chiropractors will not allow their names to be used in publicity associated with unethical office management or practice building courses, testimonials or chiropractic technique courses.

29.A chiropractor contemplating endorsing a product, company or service should do so only it it reflects favourably on the profession, and the policies of the Canadian Chiropractic Association are upheld. The names of professional bodies may not be used in conjuction with the endorsement without their expressed written consent.

30.A Chiropractor will not claim professional superiority, make invidious remarks respecting other practitioners, their services or their products, or make claims respecting products or services that are not provided as promised.

The chiropractor will respect this Code of Ethics, the Clinical Guidelines for the Practice of Chiropractors in Canada, and the provincial licensing body regulations concerning practice advertising.
32A chiropractor shall request the opinion of an appropriate chiropractor or health practitioner acceptable to the patient when diagnosis or treatment is difficult or obscure, or when the patient requests it. Having requested the opinion, the chiropractor may make available any relevant information and will clearly indicate whether the colleague is to assume the continuing care of the patient during this illness.

33..The chiropractor shall, when an opinion has been requested by a colleague, report in detail findings and recommendations to the attending chiropractor or health practitioner and may outline the opinion to the patient. Care of the patient will be continued only at the specific request of the attending chiropractor or health practitioner, and with the consent of the patient.

Patient Care

34.A chiropractor shall co-operate with those individuals who, in the opinion of the chiropractor, may assist in the most appropriate care of that patient.

35.A chiropractor may make available to a colleague, at the request of the patient, a report of findings and treatment of that patient.

36.Health services to a colleague shall be provided without fee, unless specifically requested to render an account.

37.The chiropractor who at times is practicing outside the traditional office, such as a health and / or sports club or nursing home, shall protect the doctor-patient relationship by performing in a manner consistent with proper professional services. A case history, examination in a private room, proper records, and suitable facilities for treatment are mandatory. It should be determined whether the individual is under the care of a colleague, and if so, extend no care prior to consultation with the first chiropractor.

Article III

Duties of the Chiropractor to Society

1.The chiropractor will strive to improve the standards of chiropractic services and health care in the community.

2.The chiropractor will accept full share of the chiropractic profession's responsibility to society in matters relating to spinal and public health, health education, and legislation affecting the health or well-being of the citizens of the community.

3.In the interest of providing good and competent chiropractic care, the chiropractor will support the opportunity of colleagues to obtain recognition and health privileges in the community appropriate to their personal and professional qualifications.

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