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Acupuncture Today – July, 2002, Vol. 03, Issue 07

The Spirit of the Matter -- Ethics

By Kabba Anand, DAc, LAc, Dipl. Ac., Dipl. CH

Even if you enter the profession with an innate understanding of ethics, maintaining an ethical practice requires an ongoing commitment to awareness, contemplation and self-development. As Aristotle said, "We are what we repeatedly do." It has taken me years to abandon the conditioning I received at home and at school to strive for perfection.

Instead, I now hope to continually improve myself. I just finished reading a stimulating book titled Children of Character. The premise of the book was that when we model ethical behavior, our children learn it naturally. As a practitioner, although your primary goal may not be that your clients mimic your behavior or live an ethical life, your responsibility to them is just as great, because you serve as guide, advisor, healer, confidante, etc.

As conscious health care practitioners, professional ethics define and guide much of our communication, interaction, business practice, and so on. Ethics are an ever-changing code, which makes us accountable for our actions. It is our responsibility to cultivate awareness of what is acceptable in practice as defined by our culture, the public, the AOM community and the conventional medical community.

The foundation of an ethical professional practice is to participate in life with awareness, compassion, humility and love. Lao Tzu was quoted as saying, "The sage is guided by what he feels and not by what he sees." From that foundation, you will find it easy to safely promote health and facilitate healing; serve all, regardless of nationality, race, sex, sexual preference, etc.; hold the well-being of the patient as your principal goal; respect patient confidence; model health; maintain cooperative relationships with your peers; and represent your education, certification, professional affiliations and other qualifications honestly, all without effort.

Cultivating awareness can begin with the simple practice of taking some time each day to be in silence, walk in nature, or write down your thoughts and feelings at the moment. You will find that these practices, in contrast to fulfilling desire, begin to arouse contentment.

Uncomfortable situations demand the most maturity and integrity. If you are already in practice, you may have encountered several of these situations. As an exercise, ask yourself the following questions, and write down your first response. (There are no right or wrong answers to these questions.)

  1. What methods or approaches do you employ in handling uncooperative patients?
  2. Are your boundaries around touch clearly understood and defined?
  3. What do you do if a patient flirts with you?
  4. How do you disclose treatment limitations?
  5. Are you willing to identify, address and resolve ethical issues?

My recommendations are:

  1. Deal with the issue by reviewing your policies, procedures and expectations, as well as the patient's goals. Be sure that they are all reasonable and workable.
  2. Exercise consistent boundaries around touch. Know which areas of the body are inappropriate to touch, as well as what sorts of touch might be inappropriate for you and your patients. If you find that you are not consistent in respecting these boundaries, you might have an issue that requires closer examination.
  3. An appropriate response will depend upon many factors. However, if the advance is overt and direct, it is your responsibility to communicate with your patient. Let them know that the advance was inappropriate and that it will not be welcomed in the future.
  4. Do not claim to or give the impression that your treatment can and will be the cure for all diseases. Communicate realistic potential outcomes, and set regular timelines for re-evaluation of progress.
  5. This is the most important question, as an ethical practice demands that you continually identify, address and resolve the myriad of issues that arise through professional practice.

There is an old saying: "Trust in Allah, but tie your camel." In other words, trust in your skills, awareness and understanding, but be prepared to handle unforeseen situations that might arise through applying common sense.

In order to avoid ethical issues, be sure to establish clear agreements with your patients. Review and discuss each patient's goals, as well as the possible benefits, risks, and the recommended treatment. Have each patient sign an informed consent form prior to initiating care. A patient has the right to accept or reject your recommendations or treatment. Remember that a patient's treatment may not be discontinued without medically indicated reasonable cause. Be sure to do no harm.

To avoid legal issues, maintain all necessary licenses, and be sure you can justify your treatment approach. Regularly attend continuing education courses.

To avoid malpractice issues, do not practice beyond your legal scope of practice. Always exercise technical skill and apply reasonable caution in treatment. If necessary, refer to an emergency facility or other medical consultation in a timely manner. Avoid practicing at an unreasonable pace.

To manage an ethical practice, avoid fraud in filing records or billing, and false advertising. Be sure to respond in a timely manner to a request for medical records. Avoid sexual misconduct. Never practice under the influence of drugs or alcohol.

Additionally, you may want to consider using only disposable needles, and having a system in place for disposing of other medical waste. Create an office plan for medical emergencies, and share it with all staff members. Maintain consistent fees between cash and insurance clients. Respect confidentiality. Be sure that your office is clean and comfortable. When in doubt, don't treat a patient, and reschedule if you are not in good health.

Above all, live as if today really matters. Be someone others can count on. Make your life meaningful. Honor the sanctity of human (and all) life. Create loving, trusting relationships, and appreciate what you have. We have been given a great gift and responsibility in delivering this powerful traditional medicine. Share it from your heart, with compassion, respect and grace.

Click here for previous articles by Kabba Anand, DAc, LAc, Dipl. Ac., Dipl. CH.

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