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ETHICS
 



CHIROPRACTIC CODE OF PROFESSIONAL ETHICS


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Table of Contents

Preamble

I. Duties, Obligations and Responsibilities of Chiropractors to Their Patients

II. Duties, Obligations and Responsibilities of Chiropractors to the Public

III. Duties, Obligations and Responsibilities of the Chiropractor to the Profession

IV. Enforcement

V. NYSCA Standards of Conduct

Preamble

These Canon's of Professional Ethics are based upon fundamental principles of ethics and professional behavior imposed upon all chiropractors including chiropractors and assistants who may not be engaged in active practice. The following general purposes and objectives should be considered first and foremost.

  • Consider the well-being of the patient. The ultimate goal and primary effort should be "The greatest good for the patient".

  • Honor your profession, its history and traditions.

  • Respect your patients rights of confidentiality in the doctor-patient relationship.

  • Recognize chiropractic's scope of practice and acknowledge the special skills of other health care personnel in prevention and treatment of disease.

  • Professional responsibility, integrity and competence should be your guiding tenets.

The scope of this chiropractic Code of Ethics comprises practitioners' duties and obligations to their patients, the public and each other. A code of ethics has been part and parcel of chiropractic since its inception and chiropractors should act within these general principles which have governed chiropractic practice through the years.

The ethical foundations upon which these principles are based are those established moral obligations insuring the dignity and integrity of the profession. The objective of this formal code is to clearly define the obligations and duties incumbent upon each and every chiropractor.

The first and foremost duty of every chiropractor is to abide by Federal, State, Provincial, and local statutes establishing the privileges of practicing chiropractic as well as the basic moral obligations imposed by this code of ethics.

I. Duties, Obligations and Responsibilities of Chiropractors to Their Patients

The overriding primary and ultimate objective of these guiding principles will be for chiropractic to render the greatest service and care to humankind possible.

Principle IA. Availability and Accessibility

  • Chiropractors should make themselves available but more importantly accessible to the call of ill patients who are in need of their professional services. A chiropractor shall to the best of his/her abilities and immediate circumstantial limitations, render all possible assistance to any patient(s) in emergent health care situations. A chiropractor, excepting an emergent situation shall have the right of accepting or rejecting a particular patient. Chiropractors should realize the tremendous responsibilities their vocation imposes upon them and should conduct themselves accordingly to obtain the confidence and respect of the patient.

Principle IB. Confidentiality

  • A chiropractor is obligated and bound to obtain the trust and retain the confidence of each and every patient and patient's family in the discharge of his/her professional duties. Doctors of chiropractic should preserve, protect and defend patient confidences and records. Occasional exception to this principle arises when society imposes a higher moral law requiring disclosure or when a patient consents to disclosure such as when a chiropractor is performing a service for his/her patient in the submission of information to third party payers, responsible relatives and/or guardians. Chiropractors,' unless directed by the patient or legal guardian should not discuss a patient's history, examination, symptoms, diagnosis or treatment with anyone.

The patient may expect the following basic considerations from a doctor of chiropractic in the conduct of their care regarding confidentiality.

Confidentiality

Chiropractors are encouraged to have the utmost respect and regard for the patient's privacy as outlined in this policy on confidentiality and as asserted by the entire Code of Chiropractic Professional Ethics.

  1. Providers shall not discuss patient information with one patient about another patient, or with an employee.

  2. Providers shall not discuss any patient information with relatives or friends of the patient without written patient consent.

  3. Providers shall not discuss any patient information with visitors to the office or hospital without written patient consent.

  4. Patient information should not under any circumstances be discussed with the news media without patient consent.

  5. Providers should not discuss patient information with other employees, except in conference and/or consultation. Discussion about patients should be avoided in any patient areas. Always be mindful of the patients privacy, when consulting another chiropractor or health care provider keep volumes low.

  6. Do not discuss patient information with your own relatives or friends outside the office or hospital.

  7. Do not discuss any patient information over the telephone with anyone without the patient's written consent.

Confidentiality of Medical/Health Care Records

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) stipulates the following minimum standards in regard to assessing hospital accreditation compliance with medical records taking and confidentiality of the information contained therein. The New York State Chiropractic Association endorse these standards in principle.

  • Medical records are confidential, secure, current, authenticated, legible, and complete.

  • The medical record is the property of the hospital/office and is maintained for the benefit of the patient, the medical/healthcare staff, and the hospital or office.

  • The hospital or office is responsible for safeguarding both the records and its informational content against loss, defacement, and tampering and from use by unauthorized individuals.

  • Written consent of the patient or his legally qualified representative is required for the release of medical information to persons not otherwise authorized to receive the information.

  • Where certain portions of the medical record are so confidential that extraordinary means are necessary to preserve their privacy, such as in the treatment of some psychiatric disorders, these portions may be stored separately, provided the complete record is readily available when required for current medical care or follow-up, review functions, or use in quality assurance activities.

Principle IC. Limits of Chiropractic Care

  • Chiropractors shall assume the highest standards of moral conduct. Absolute honesty and integrity should characterize all transactions with his/her patients and the public they serve.

  • A chiropractor shall endeavor to attend to his/her patients as often as they might consider necessary to ensure the well-being of their patients, and their continued favorable progress, however, chiropractors shall strive to scrupulously avoid unnecessary treatment and care and therefore shall eschew practice building and management strategies that advocate contractual patient care.

  • Chiropractors shall neither exaggerate nor minimize the gravity of a patient's condition, nor offer any false hope or prognosis. It is also the chiropractor's duty to acquaint some judicious friend or relative of the patient with the actual facts of a particular care when a patient appears incapable of caring for themselves.

  • Once committed to serving a patient, doctors of chiropractic shall endeavor to avoid neglecting a patient. Reasonable care should be taken to protect the patients welfare. Chiropractors should not terminate their professional services without due notice allowing patients reasonable time to obtain professional or alternative services elsewhere and giving to their discharged patients papers and documents as necessary in compliance with these ethical canons.

  • Doctors of Chiropractic owe their patients loyalty, compassion and respect. Chiropractic clinical judgment and practice should be as objective as possible and exercised solely for the patient's benefit.

Principle ID. Release of Confidential Patient Records

  • Chiropractors shall comply with a patient's written authorization to provide records, copies of records to individuals the patient designates as authorized to inspect or receive all or part of said records. Further, chiropractors shall abide by the general standards for patient record confidentiality and release promulgated by the American Medical Records Association as put forth below. Reasonable charges may be assessed of the patient for the cost of duplicating records.

The following statements are given in the position statements of the American Medical Records Association, and are also endorsed by the New York State Chiropractic Association and henceforth part of the NYSCA Code of Professional Ethics.

  • All requests for health records or health information shall be referred to the health record department.

  • Release of health information to the patient shall be carried out in accordance with all applicable legal requirements and written institutional policy. A properly completed and signed authorization is required.

  • Subject only to specific contraindications described below, and to any legal constraints such as those governing minors and those adjudicated as incomplete, a patient or his representative may have access to his own health record for review, upon written request with reasonable notice. A patient may have access to records of his care during or after discharge from treatment. A copy of the requested health information will be provided after completion and upon written request by the patient and payment of a reasonable fee.

  • The health care provider is not required to permit the patient access to his [her] health record if the provider reasonably concludes that:

    • Knowledge of the health care information would be injurious to the health of the patient, or

    • Knowledge of the health care information could reasonably be expected to cause danger to the life or
      safety of any person.

  • If the health care provider denies a patient's request to see or copy, in whole or in part, his health record based on the above grounds, the provider must either:

    • Provide a summary of the health record, according to the requirements of this section. If the health care provider chooses to prepare such a summary of the record rather than allow access to the entire record, he or she shall make such a summary of the records available to the patient within ten (10) working days from the date of the patient's request. However, if more time is needed because the record is extraordinary in length or because the patient was discharged from a licensed health facility within the last ten (10) days, the health care provider shall notify the patient of this fact and the date that the summary will be completed, but in no case shall more than thirty (30) days elapse between the request by the patient and the delivery of the summary. In preparing the summary of the record, the health care provider shall not be obligated to include information which is not contained in the original record; or

    • the provider must permit inspection by, or provide copies of, the health record to another health care practitioner who is licensed to treat the same condition as the health care provider and who has been so designated, in writing, by the patient. The health care provider shall inform the patient of the provider's refusal to permit him or her to inspect or obtain copies of the requested records, and inform the patient of the right to require the provider to permit inspection by, or provide copies to, another health care practitioner who is licensed to treat the same condition as the health care provider and who has been so designated, in writing, by the patient.

  • In either event, the health care provider shall make a written record, to be included with the health records requested, noting the date of the request and explaining the health care provider's reason for refusing to permit inspection or provide copies thereof, including a description of the specific adverse or detrimental consequences to the patient which the provider anticipates would occur if inspection or copying were permitted.

  • In the event that the patient wishes to correct data, it shall be done as an amendment, without change to the original entry, and shall be clearly identified as an additional document appended to the original health record at the direction of the patient. This document shall then be regarded as an integral part of the health record. Upon request of the patient, the provider will furnish copies of the amendment to any person to whom the disputed information has been properly released. Whenever health information is request subsequent to the amendment, the copy sent shall include the amendment.

  • The provider will make these policies known to patients upon request.

  • Following authorized release of patient information, the signed authorization will be retained in the health record with notation of the specific information released, the date of release and the signature of the individual who released the information.

Release of Primary Records

  • All requests for health records of health information, including requests for information on patients currently under treatment, shall be directed to the health record department or office manager.

  • Release of information from the health record shall be carried out in accordance with all applicable legal, accrediting, and regulatory agency requirements, and in accordance with written institutional policy.

  • All information contained in the health record is confidential and the release of information will be closely controlled. A properly completed and signed authorization is required for release of all health information except:

    • As required by law

    • For release to another health care provider currently involved in the care of the patient

    • For medical care evaluation; or

    • For research and education in accordance with conditions specified below

  • In keeping with the tenet of informed consent, a properly completed and signed authorization to release patient information shall include at least the following data:

    • Name of institution that is to release the information

    • Name of the individual or institution that is to receive the information

    • Patient's full name, address and date of birth

    • Purpose or need for information

    • Extent or nature of information to be released, with inclusive dates of treatment (Note: An authorization specifying "any and all information..." shall be honored)

    • Specific date, event or condition upon which authorization will expire unless revoked earlier

    • Statement that authorization can be revoked but not retroactive to the release of information made in good faith

    • Date that consent is signed (Note: Date of signature must be later than the date of information to be released), and

    • Signature of patient or legal representative (Note: In the case of treatment given a minor without parental knowledge, the institution shall refrain from releasing the portion of the record relevant to this episode of care when responding to a request for information for which the signed authorization is that of the parent or guardian. An authorization by the minor shall be required in this instance.

  • Information released to authorized individuals/agencies shall be strictly limited to that information required to fulfill the purpose stated on the authorization. Authorizations specifying "any and all information..." or other such broadly inclusive statements shall not be honored. Release of information that is not essential to the stated purpose of the request is specifically prohibited.

  • Following authorized release of patient information, the signed authorization will be retained in the health record with notation of the specific information released, date of release and signature of the individual who released the information.

  • Health records shall be available for use within the facility for direct patient care by all authorized personnel as specified by the chief executive officer or office manager, and documented in a policy manual.

  • Direct access to health records for routine administrative functions, including billing, shall not be permitted, except where the employees are instructed in policies on confidentiality and subject to penalties arising from violation.

  • Health records shall be available, in the health record department, to authorized students enrolled in educational programs affiliated with the institution. Students must present proper identification and written permission of the instructor with their request. Data compiled in educational studies may not include patient identity or other information which could identify the patient.

  • Health records shall be made available for research to individuals who have obtained approval for their research projects from an institutional review board or appropriate medical staff committee, administrator or other designated authority. Research projects which involve use of health records shall be conducted in accordance with institutional policies on the use of health records for research. Any research project which involves contact of the patient by the researcher must have written permission of the patient's attending physician, and/or by the chief executive officer of the facility or his designee, prior to contact. An institutional policy on use of medical records in research should guide these activities.

  • If facsimiles of health records are provided to authorized internal users, the same controls will be applied for return of these facsimiles as for return of the original health record. Wherever possible, internal users will be encouraged to use the original health record rather than to obtain a facsimile.

  • The names, addresses, dates of admission or discharge of patients shall not be released to the new media or commercial organization without the express written consent of the patient or his authorized agent.

  • Requests for health information received via telephone will require proper identification and verification to assure that the requesting party is entitled to receive such information. A record of the request and information released will be kept.

Principle IE. Patients Bill of Rights Within the Health Care Setting

The basic rights of human beings for independence of expression, decisions and action and concern for personal dignity and human relationships are always of great importance.

A patient should expect and shall receive the following rights imposed upon chiropractors engendered with the responsibility of delivering chiropractic care. These rights are enumerated in the chiropractic Code of Ethics and shall be transmitted to the patient.

  1. Chiropractors shall accord the patient impartial access to treatment without regard to race, sex; cultural, national, or ethnic origins; economic, educational, religious or political affiliation or the source of payment for his/her care.

  2. Chiropractic care shall always and everywhere be considerate toward the patient and respectful of the patient's personal dignity.

  3. The patient can expect to be interviewed and examined in surrounding designed to assure reasonable visual and auditory privacy. This includes the right to have a person of one's own gender present during certain portions of a physical examination, performed by a health professional of the opposite sex and the right not to remain disrobed any longer than is required for accomplishing the health care purpose for which the patient was asked to disrobe.

  4. The patient should have known the identity and professional status of individuals providing service to him/her and to know which has primary responsibility for coordinating his/her care and the names and professional relationships of other physicians who will also be responsible for his/her care. This includes the right to know of the existence of any professional relationship among individuals who are treating him/her as well as the relationship to any other health care or educational institution involved in his/her care.

  5. The patient can expect to receive information from the chiropractor/physician coordinating his/her care and current information concerning the diagnosis, prognosis and the planned course of treatment in terms that they are able to understand. When it is not medically advisable to give such information to the patient, the information should be made available to a legally authorized representative of the individual.

  6. The patient is entitled to receive as much information about proposed treatments or procedures as he/she may need in order to grant or refuse to give consent to any procedure(s), treatment(s) or course of action. Other than emergent situations, the information given to the patient shall include a description of the procedures or treatment, the significant health risks involved in this treatment, alternative course of treatments or nontreatment and the attendant risks involved with each. The patient is also entitled knowledge of the person(s) responsible for authorizing or carrying out any procedures or treatments.

  7. The patient can expect to participate actively in any and all decisions regarding his/her treatment and care. To the extent permissible by applicable law, this will include the right to refuse treatment and is entitled to be informed of any adverse consequences of his/her decision. When refusal of treatment by the patient or legally authorized representative prevents the provision of appropriate care in accordance with professional standards, the relationship with the patient may be terminated upon reasonable notice.

  8. The patient has the right to reasonably informed participation in decisions involving his/her health care. To the degree possible, this should be prefaced upon clear, concise explanation of his/her condition, all proposed technical procedures, including any possible risk (see informed consent) of mortality or serious side effects, problems related to recuperation and probability of success. The patient should not be subjected to any procedure(s) without voluntary, competent, and understanding consent or that consent of his/her legally authorized representative. Where medically significant alternatives for care or treatment exist, the patient shall be so informed.

  9. The patient shall receive full consideration of privacy concerning his/her health care program. Case discussion, consultation, examination and treatment are confidential and should be conducted discretely and individuals not directly involved in his/her care will not be present without his permission. The patient has the right to be advised of the presence of any individuals and the reason for their presence.

  10. The patient is entitled to confidential treatment of all communications and records pertaining to his/her care. To have his/her health care record read only by individuals directly involved in his/her treatment or in monitoring of its quality and by other individuals only on his/her written authorization or that of his legally authorized representative. Written permission shall be obtained before any health care records can be made available to anyone not directly concerned with the patient's care. The patient may also refuse to talk with or see anyone not officially connected with the hospital or private office, including visitors.

  11. The patient can expect that all communications and other records pertaining to his/her care, including the source of payment for treatment, to be treated as confidential information.

  12. The patient shall receive reasonable responses from any and all providers to any reasonable request he/she may make for service.

  13. The patient shall be permitted to leave or otherwise voluntarily be discharged from chiropractic care even against the best advice of the attending chiropractor.

  14. Patients can expect reasonable continuity of care. They shall be informed in advance of the time(s) and location(s) of appointments as well as the name and capacity of the chiropractor that will be providing care.

  15. Patients will be advised if chiropractors and/or other attending physicians or other concomitant health care personnel propose to engage in or otherwise perform human experimentation affecting his/her care or treatment. The patient has the privilege and right of refusing to participate in any research projects. Participation by patient in clinical training programs or in the gathering of data for research purposes should always and everywhere be voluntary.

  16. The patient shall be informed by his/her chiropractor or a delegate of the chiropractor of continuing health care requirements following discharge from care in the out-patient or in-patient setting.

  17. The patient shall have upon request, the right and courtesy of receiving an itemized, detailed and thorough explanation of his/her total charges billed for services rendered regardless of the source of payment. The patient has the right to timely notice prior to termination of his/her eligibility for reimbursement by any third-party payer for the cost of his/her care, if and when the doctor is notified by the third party payer.

  18. The patient shall be advised of his/her rights and shall be instructed as to the rules and policies which apply to his/her conduct as a patient in the out-patient and/or in-patient setting.

  19. The patient shall have all their rights also applied to the person or persons who may assume the legal responsibility to make decisions on the patient's behalf regarding the care of the patient should the patient be a legal minor or otherwise incapacitated.

  20. The patient has the right to expect reasonable safety insofar as the health care environment is concerned.

  21. The patient at his/her own request and expense has the right to consult with any other health care provider.

  22. The patient should be informed of the office/practitioner rules and regulations applicable to his/her conduct as a patient prior to the commencement of any care or treatment procedures.

No catalog of rights can guarantee for the patient the kind of treatment he/she has a right to expect. Physicians, chiropractors, hospitals and offices have many functions to perform, including the prevention and treatment of disease, the education of other health professionals and patients, and the conduct of clinical research. All these activities must be conducted with an overriding concern for the patient, and, above all, the recognition of his/her dignity as a human being. Success in achieving this recognition assures success in the defense of the rights of the patient.

Patient Responsibilities

 

  1. Provision of Information

    A patient has the responsibility to provide, to the best of his knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his/her health. He has the responsibility to report unexpected changes in his condition to the responsible practitioner. A patient is responsible for making it known whether he clearly comprehends a contemplated course of action and what is expected of him/her.

  2. Compliance with Instruction

    A patient is responsible for following the treatment plan recommended by the practitioner primarily responsible for his/her care. This may include following the instructions of nurses and allied health personnel as they carry out the coordinated plan of care and implement the responsible practitioner's orders, and as they enforce the applicable hospital rules and regulations. The patient is responsible for keeping appointments and, when he is unable to do so for any reason, for notifying the responsible practitioner or office.

  3. Refusal of Treatment

    The patient is responsible for his actions if he refuses treatment or does not follow the practitioner's instructions.

  4. Charges

    The patient is responsible for assuring that the financial obligations of his/her health care are fulfilled as promptly as possible.

  5. Health Care Rules and Regulations

    The patient is responsible for following office rules and regulations affecting patient care and conduct.

  6. Respect and Consideration

    The patient is responsible for being considerate of the rights of other patients and for assisting in the control of noise, smoking, and the care and control of infants and children. The patient is also responsible for being respectful of the property of other persons and of the offices and environment in which care was rendered.

References:

  • AHA Patient's Bill of Rights, American Hospital Association, Chicago, Illinois

  • AMH/87: Accreditation Manual for Hospitals, Joint Commission on Accreditation for Hospitals, 875 North Michigan Avenue, Chicago, Illinois 60611, 1986

Principle IF. Informed Consent

A significant amount of malpractice contended in lawsuits is attributable to the concepts engendered in Informed Consent. In this regard according to the Joint Commission on Accreditation of Healthcare Organizations,

"The patient has the right to reasonable informed participation in decisions involving his health care. To the degree possible, this should be based on a clear, concise explanation of his condition and of all proposed technical procedures, including the possibilities of any risk of mortality or serious side effects, problems related to recuperation, and probability of success. The patient should not be subjected to any procedures without his voluntary, competent, and understanding consent or that of his legally authorized representative. Where medically significant alternative for care or treatment exist, the patient shall be so informed."


"The patient has the right to know who is responsible for authorizing and performing the procedures or treatment."


"The patient shall be informed if the hospital proposes to engage in or perform human experimentation or other research/educational projects affecting his care or treatment, and the patient has the right to refuse to participate in any such activity." (AMH/87 p.xiii)

When a procedure is carried out on a patient by employees of the hospital, the hospital has a responsibility to insure that the patient is sufficiently informed of the events beforehand and that acknowledgement by permission was obtained from the patient.

There are two basic kinds of consents with which hospitals and independent "private" practitioners have to concern themselves. These are "express" consent and "implied" consent.

  • Express consent is permission granted by the patient to the provider and or health care facility in their own words. The consent may be written or spoken, but written consent is always preferable to trying to establish verbal consent after an event has taken place. Written consent nevertheless, is not iron clad. Several courts have found written consent insufficient when the patient, even knowledgeable of the procedures experienced an untoward effect. In these type instances, written consent absolves provider of negligence by omission to some degree, but not by commission.

  • Implied consent is that which is generally inferred by the patients conduct. When a patient apparently knowingly and voluntarily submits to a procedure(s), this is considered implied consent despite the fact that there was no verbal exchange communicating permission or written consent.

Principle IG. Freedom of Choice

  • Chiropractors shall recognize the right of patients to select his or her own method of health care and their desires in this regard shall be respected. The patient shall have the right to select the mode of professional care of his or her choice. Doctors of chiropractic shall also respect the patients right to change their choice of providers at will. This may be separate or complimentary to chiropractic care where cooperation with another provider may be required and concurrent procedures do not conflict.

  • In regard to the chiropractic mode of care, doctors of chiropractic should insure that patients possess enough information to enable the patient to make an informed, intelligent decision with regard to any proposed chiropractic treatment.


Principle IH. Timely Consultation

  • In difficult or protracted cases consultation(s) with other health care providers are recommended and advisable and chiropractors shall be ready to act upon any expressed patients' desires for a consultation with another chiropractor or provider even though he/she may not feel the need for consultation. Doctors of chiropractic shall stand ready to seek the talents of other health-care providers when a consultation would benefit their patient.

Principle II. Remuneration

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

  • Doctors of chiropractic are entitled to receive proper and reasonable compensation for their professional services commensurate with the value of his/her personal services rendered compared to the fees commonly assessed in the community by other members of their profession based on usual and customary practices; experience, time, reputation, the nature of the patient's condition and the patient's ability to recompense. Chiropractors should be prepared to discuss their fees with individual patients and should initiate discussions when fees are expected to exceed usual and customary charges.

  • Chiropractors should support proper activities designed to enable access to necessary chiropractic care on behalf of individuals unable to pay reasonable chiropractic fees or are otherwise legally destitute.

Principle IJ. Termination of Patients

  • Since patients have the right or privilege to dismiss providers at will for reasons satisfactory to him/herself, likewise, chiropractors may decline to attend patients when professional self-respect and dignity require this action. Chiropractors are encouraged to terminate professional doctor-patient relationships when it becomes reasonably clear that the patient is not benefitting from it.

  • Having accepted a patient or patient(s), a chiropractor shall never abandon a patient without due regard for the patients welfare. If a chiropractor decides to withdraw from a particular case, the patient or the patient's legal representative shall be given sufficient notice to secure other provider attendance if they so desire.

Principle IK. Guarantees

  • A chiropractor shall not offer or guarantee a cure to any patient either verbally or in writing.

  • A chiropractor may give a patient a reasonable estimate regarding the length of time/number of visits the may be required to favorably advance a particular condition. Chiropractors however, should scrupulously avoid protracted or unnecessary care without some favorable remission of the patients complaint(s).

Principle IL. Practices of Questionable Propriety

  • Chiropractors shall avoid participation or assistance in all practices of questionable propriety, either with his/her patients, colleagues, family or other business associates.

  • Chiropractors shall conduct their practices in a surrounding which will not compromise the quality of patient care.

  • A chiropractor shall not initiate or otherwise, knowingly participate in any illegal, fraudulent actions. They should maintain the highest standards insuring that his/her conduct in professional practice is above reproach. Chiropractors will refrain from any and all legal and morally reprehensible conduct and will not take physical, emotional or financial advantage of any patient or the public they serve.

Principle IM. Diagnostic Procedures

  • Chiropractors shall recommend and use only those diagnostic procedures, laboratory and imaging techniques allowable by applicable state and/or provincial code, that are in the best interests of the patient; will assist in the patients' diagnosis and care, and are necessary for the well-being of the patient. Furthermore, chiropractors shall recognize his/her responsibility in advising patients of the diagnostic findings and any attendant recommendations therefrom.

  • Patients should be adequately prepared for examination and/or treatment.


Principle IN. Patient Benefits

  • A chiropractors shall be required to assist patients in securing any benefits due the patient by supplying the information required, if available, in response to a patient's request for
    assistance.

  • When acting at the request of a third or other party, the chiropractor will insure that the patient understands the chiropractor's legal responsibility before conducting any examination and/or treatment procedures.

Principle IO. Equality

  • Chiropractors shall recognize the responsibility of rendering responsible chiropractic care to any and all individuals regardless of race, sex; cultural, national or ethnic origins; political persuasions or ability to recompense.

Principle IP. Practice Aims

  • In all endeavors of professional practice, chiropractors shall practice with the utmost courtesy, honesty and highest degree of professional competence in the proper care of the patients with due regard and respect for the patient's unequivocal rights and personal dignity.

  • The ultimate end is the "greatest good for the patient."


II. Duties, Obligations and Responsibilities of Chiropractors to the Public

Personal and Professional Conduct

Principle IIA.
Demands upon the profession

  • Doctors of chiropractic shall recognize that as members of a learned profession dedicated to the promotion of health, the prevention of illness and the alleviation of suffering, they shall act accordingly realizing that the public demands of him/her integrity and dedication to its search for truth in its service to humankind.

  • A chiropractor shall recognize that self-discipline of the profession is a privilege and that he/she has a responsibility to merit the retention and respect of the public for this privilege.

  • A chiropractor shall conduct him/herself in such a manner as to merit the respect of the public for members of the chiropractic profession

  • A chiropractor shall protect his professional independence by avoiding all situations which would lead to a conflict of interest.

  • Chiropractors who are also public officers, either elected or appointed, full or part-time, should not engage in activities which are, or may be perceived to be, in conflict with their official duties.

Principle IIB. Observance of Law and Codes

  • Doctors of chiropractic should observe the appropriate laws, decisions and regulations of state governmental agencies and cooperate with the pertinent activities and policies of associations legally authorized to regulate or assist in the regulation of the chiropractic profession.

  • The chiropractic profession should address itself to improvements in licensing procedures consistent with the development of the profession and of relevant advances in science.

Principle IIC. Participation in Community Affairs

  • A chiropractor should participate as a responsible citizen in the public affairs of their local community, state and nation in order to improve law, administrative procedures and public policies that pertain to chiropractic and the system of health-care delivery. A chiropractor should stand ready to take the initiative in the proposal and development of measures to benefit the general public health and well-being, and should cooperate in the administration and enforcement of such measures and programs to the extent consistent with the law.

Principle IID. Professional Advertising

  • A chiropractor shall strive to build a professional reputation based on his/her ability and integrity, will avoid commercial advertising in the various media which is not in accordance with New York State Regulations.

  • A chiropractor may advertise but should exercise utmost care that such advertising is relevant to the selection of a chiropractor, is accurate, truthful, not misleading or false or deceptive, and scrupulously correct in representing the chiropractor's professional status and area of special competence as provided for by New York State Regulations. Communications to the public should not appeal primarily to an individual's anxiety or create unjustified expectations of results. A chiropractor should conform to all applicable state laws, regulations and judicial decisions in connection with professional advertising.

  • The advertising of free x-ray (radiology, roentgenological) examinations to the public and patients is injurious to the public's health and safety and is expressly forbidden. It is well known that roentgenological examinations of bodily parts have a cumulative effect. Injudicious use or advertisement of free examinations is not in the best interests of patients or the public.

Principle IIE. Depositions

  • A chiropractor may testify either as an expert or when their patients are involved in legal proceedings, workers compensation cases or in other similar administrative proceedings in personal injury or related cases.

Principle IIF. Competency

  • A chiropractor should continually strive to improve their skill and competency by keeping abreast of current developments contained in the health and scientific literature, and by participating in continuing chiropractic educational programs and utilizing all other appropriate means.


III. Duties, Obligations and Responsibilities of the Chiropractor to the Profession

Principle IIIA.
Responsibility to the Chiropractic Profession

  • A chiropractor should assist in maintaining the integrity, competency and highest standards of the chiropractic profession.

  • A chiropractor should by his/her behavior, avoid the appearance of professional impropriety and should recognize that their public behavior may have an impact on the ability of the profession to serve the public. Chiropractors should endeavor to promote public confidence in the chiropractic profession.

  • A chiropractor shall avoid impugning the reputation of his/her colleagues.

  • A chiropractor shall conduct him/herself beyond reproach and will report to the appropriate body of his/her profession, peers or association, conduct by a colleague which he/she considers unbecoming to the chiropractic profession.

  • A chiropractor should promote and maintain cordial relationships with other members of the chiropractic profession and other professions for the exchange of information advantageous to the public's health and well-being.

  • A chiropractor shall provide health services to a colleague without fee, unless specifically requested to render an account. Doctors of chiropractic shall provide health services without fee to their immediate families (mother, father, brother(s), sister(s), grandparent(s), in-laws and spouse).

Principle IIIB. Contractual Arrangements

  • A chiropractor shall, when aligning him/herself in practice with other chiropractors, insist that they maintain the standards enunciated in this Code or Professional Ethics and the provisions of the respective Chiropractic Act.

  • A chiropractor shall only enter into a contract, regarding his/her professional services, which allows fees derived from chiropractic services to be controlled by the chiropractor rendering the service.

  • A chiropractor shall enter into a contract with an organization only if it will allow him/her to maintain his/her professional integrity.

  • A chiropractor shall only offer a colleague a contract which has terms and conditions equitable to both parties.

Principle IIIC. Research and Study

  • A chiropractor shall first communicate to his colleagues or appropriate chiropractic institution of learning through -recognized scientific channels, the results of any chiropractic research, in order that those colleagues may establish an opinion of its merits or veracity before he or they present it to the public.

  • A chiropractor, as a teacher, should realize his/her obligation to assist colleagues acquire knowledge and skill in the practice of the profession. Chiropractors should endeavor to maintain the highest standards of scholarship, education, training and objectivity in the accurate and full dissemination of information and ideas.

  • A chiropractor shall recognize his/her responsibility to give the generally held opinions of the profession when interpreting scientific knowledge to the public and in presenting any personal opinion which is contrary to the generally held opinion of the profession, he/she will indicate they are doing so, and will avoid any attempt to enhance his own professional reputation.

  • A chiropractor shall not indicate to the public a level of competence greater than that which he actually holds, according to accepted standards.

  • A chiropractor should share, with his colleagues, new technique methods, devices of appliances that might be applicable to the practice of chiropractic. It is the duty of the chiropractor to avail himself of every opportunity to observe the action and study the merits of all new types of technique or methods of procedure in the application of chiropractic principles.

Principle IIID. Consultation

  • A 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 indicate clearly whether he wishes his colleague to assume the continuing care of the patient during this illness.

  • A chiropractor shall, when his opinion has been requested by a colleague, report in detail his findings and recommendations to the attending chiropractor or health care provider and may outline his opinion to the patient. He will continue with the care of the patient only at the specific request of the attending chiropractor or health care provider, and with the consent of the patient.

  • A chiropractor shall cooperate with those individuals who, in the opinion of the chiropractor, may assist in the most appropriate care of that patient.

  • A chiropractor shall make available to a colleague, on the request of the patient, a report of his findings and treatment of that patient.

IV. Enforcement

Principle IVA. Disciplinary/Corrective Action, obligations of the member(s), the profession and the association to the profession, and the public

Whenever the activities or professional conduct of any individual who is a member of the Association are reasonably considered to be lower than the standards or goals of the Association membership, have the potential for injury to the public chiropractic serves, or to be unreasonably detrimental to the efficient and effective operations of the association, disciplinary/corrective action against such practitioner may be requested.

Principle IVB. Parameters of Disciplinary/Corrective Action

The New York State Chiropractic Association is a voluntary membership organization. The Association aspires to maintain the highest standards in the profession of chiropractic. Membership in the Association is a privilege and not a right. Nevertheless, the New York State Chiropractic Association is not an agency of the State of New York and therefore has no statutory authority to conduct investigations other than those that affect membership in the Association. The Association through the maintenance of standards, the examination of applications and the granting of membership has the moral prerogative to guard the standards against defilement. The Association therefore maintains this code of ethics to safeguard the public and the profession, and may conduct disciplinary/corrective actions for infractions of this code.

Disciplinary/Corrective action may consist of:

  • issuance of confidential written warning(s), formal letter(s) of reprimand or censure to be placed in the members permanent file

  • temporary or permanent reduction, suspension, or revocation of membership and its privileges

  • notification of appropriate state agencies of adverse disciplinary actions

  • documentation of such disciplinary/corrective action shall become a part of the subject practitioner's membership file

  • with regard to non-adverse recommendations only, the subject practitioner shall have the right to include a written response concerning allegations and/or documentation, in his/her membership files.

Principle IVC. Disciplinary/Corrective Action Procedures

The process of Disciplinary/Corrective action against a practitioner/member of the Association shall be procedural, summary or automatic.

The outcome or recommendations of the disciplinary/corrective actions proceedings may or may not be deemed adverse as defined below.

Summary or automatic actions may not be taken except in cases where there is a criminal violation(s) of the laws of the State of New York or in cases where the State has suspended, revoked or ordered surrendered a practitioners license for due cause.

Principle IVD. Adverse Recommendations and Decisions Defined

  1. The following recommendations or decisions are adverse when made pursuant to the disciplinary/corrective actions of this code and will automatically initiate due process procedures as outlined herein:

    • Suspension or Revocation proceedings of Association Membership

    • Temporary or Permanent Suspension or Revocation of Association Membership

    • Temporary or Permanent Reduction of Association Membership Privileges (eg. voting privileges, ability to hold office, etc.)

    • Modification, limitations or changes in subsequent membership privileges as a result of previous disciplinary/corrective action.

  2. Any and all of the foregoing adverse actions become a part of the practitioner's permanent membership record. The content of adverse actions are considered confidential between the association and subject practitioners. The only information available for public disclosure is whether or not a practitioner has had disciplinary/corrective actions in the form of letters of warning, reprimand or censure, temporary adverse action or, complete and full adverse action taken against them, the nature of the disciplinary/corrective action and the time constraints relating to such activity but not the content of the disciplinary/corrective action or the proceedings leading to its imposition. The association will only release the content of the disciplinary/corrective actions and proceedings pertaining thereto and any other information from a member's file upon receipt of a written, signed and notarized statement authorizing release from the subject practitioner(s).

Principle IVE. Non-adverse Findings and Recommendations

A. The following actions are non-adverse when made pursuant to the disciplinary/corrective actions of this code.

  • the issuance of written warnings, formal letters of reprimand and/or censure, or any other actions except those specified in Principle IVD above, shall not be deemed adverse but will entitle the practitioner to any hearing or appellate review rights as defined by Due Process Hearings contained herein.

  • The hearing provided in Principle IVG is a procedural right of the practitioner and must be conducted in accordance with the procedural rules provided in this code and in accord with the New York State Chiropractic Association's Constitution and Bylaws.

B. Classifications, time-limits and restrictions imposed by non-adverse actions.

  • the content of written warnings, formal letters of reprimand and/or censure are considered confidential between the association and subject practitioners. The only information available for public disclosure is whether or not a practitioner has had disciplinary/corrective actions in the form of letters of warning, reprimand or censure, taken against his or her, or not, the nature of the infraction and the time constraints relating to such activity. The association will only release the content of the disciplinary/corrective actions and proceedings pertaining thereto and any other information from a member's file upon receipt of a written, signed and notarized statement authorizing release from the subject practitioner(s).

  • written letters of warning(s) are confidential and will be placed in the practitioner's permanent membership file for a period of two (2) years after which they maybe removed from the record unless a new infraction results in subsequent hearings during the two year term, in which case the letters of warning are renewed at the conclusion of each hearing for an additional term.

  • formal letters of reprimand are confidential and will be placed in the practitioner's permanent membership file for a period of three (3) years after which they may be removed from the file. New infractions during the intervening three year period result in a renewal of the reprimand for an additional term from the time the new infraction is imposed.

  • letters of censure are confidential and will be placed in a practitioner's permanent membership file indefinitely and are not subject to removal.

Principle IVF. Chronology of Offenses and Disciplinary/Corrective Actions

  • First-time transgressions provided no criminal violations are involved will receive a letter of warning

  • Three or more letters of warning for different offenses in a file will initiate a letter of censure

  • Second offenses of a particular infraction will elevate the level of offense to either a letter of reprimand or a letter of censure at the discretion of the Board of Directors.

  • Third time offenses for a particular infraction or, two letters of censure or reprimand for two different infractions, or a letter of censure and a letter of reprimand for two different infractions will subject the practitioner to a temporary adverse action, such as temporary suspension of some membership privileges.

  • Fourth time offenses or, individuals subject to temporary adverse action(s) qualify the offending practitioner to a more complete adverse action such as suspension of membership and all its privileges

  • Criminal prosecution and conviction of the laws of the state of the New York or revocation, suspension or ordered surrender of a practitioner's New York or other state chiropractic license shall subject the practitioner to immediate adverse action in the manner outlined further herein.

Principle IVG. Categories of Disciplinary/Corrective Actions

1. PROCEDURAL ACTION

Prior to initiating adverse or non-adverse corrective action against a practitioner the following procedures will be followed:

A. Procedural Action Scheme

  1. Submission of written, signed and notarized statement of allegations outlining charges against a practitioner member(s).

  2. Written notification of the subject practitioner(s) within fourteen (14) days by registered mail plus reasonable time for posting by mail (three [3] days).

  3. Convocation of a Board of Inquiry within sixty (60) days of the notification of the subject practitioner(s). A Board of Inquiry will be constituted as prescribed further herein.

  4. The Board of Inquiry shall conduct hearings, receiving testimony, documentation and materials as necessary to review the charges material to the action sought. The subject practitioner may be represented by counsel and will be availed of the opportunity to rebut testimony presented.

  5. Findings and recommendations of the Board of Inquiry will be reviewed by the New York State Chiropractic Association Ethics Committee within thirty (30) days of the report of the Board of Inquiry proceedings.

  6. The Ethics Committee will advance their findings and recommendations to the Board of Directors for review.

  7. The Board of Directors at their next available scheduled meeting will review the recommendations of the Board of Inquiry and Ethics Committee. After review the Board of Directors will vote by simple majority on a recommendation of adverse actions, non-adverse actions or a reduction or elimination of all charges. Adverse recommendations by the Board of Directors, Ethics Committee and Board of Inquire will be passed on to the House of Delegates for their earliest possible meeting. Non-adverse actions will be meted-out by the Board of Directors and become part of the subject's records.

  8. The House of Delegates upon review of the findings and recommendations of the Board of Inquiry, Ethics Committee and Board of Directors will effect the final decision by a simple majority vote.

  9. After an adverse action, the subject practitioner(s) may request an appellate review hearing by the Board of Directors within thirty (30) days of the House vote and imposition and upon the submission of new evidence in the subjects favor.

  10. The findings and recommendations of the appellate Board of Directors hearings are final.

B. Charges

No less than five (5) regular members in good standing may file charges against any other member when sufficient cause exists by filing a written and signed notarized affidavit of such charges with the Secretary of this organization. The affidavit shall detail the allegations against the individual(s) and shall be supported by reference to the specific activities or conduct which constitute the grounds for the request.

C. Board of Inquiry Hearings

Within sixty (60) days thereafter, a hearing shall be held before a Board of Inquiry consisting of two (2) official and voting members from the Board of Directors, the association legal counsel [a non-voting panel member], and three (3) official and voting members from the House of Delegates to be chosen by the President of the organization at his/her discretion. The President shall also select the time and place of the hearing and the Chairman of the Board of Inquiry. No less than five (5) accusers must be present at the hearing.

In the event that the President is the member charged, the Vice President shall exercise the powers of the President relative to the selection of the members of the Board of Inquiry and Chairman thereof and relative to the selection of the time and place of the hearing.

The Secretary shall send a copy of the affidavit by registered mail within seven (7) days of the filing to the accused together with a notice of the time and place of the hearing. Said notice(s) must be given at least thirty (30) days prior to the hearing. Either side shall have the right to an attorney at his/her/their own expense.

The Board of Inquiry shall hear the evidence relevant to the charges including but not limited to testimony, documentation and submitted materials. A written record reflecting the substance of the hearing must be made and transmitted to the practitioner and the Board of Inquiry and should be available for review by the Ethics Committee and Board of Directors for their respective reviews under appropriate circumstances. Written records and transcripts of hearing procedures shall be numbered and assigned to individuals by the association. The written records and transcripts are considered confidential. They will be distributed to duly convened meetings of the Board of Inquiry, NYSCA Ethics Committee and meetings of the Board of Directors only and will be signed-in and signed-out only by the official members of such Boards and Committees and collected prior to adjournment of any such meetings. Only the subject practitioner will be permitted to keep his/her record for their personal review.

The Board of Inquiry shall entitle subject practitioner(s) the right to rebut testimony related to the charges but shall not permit him/her to cross-examination of those submitting testimony. Cross-examination, if any, will be conducted by the Board of Inquiry. The Board shall also allow the subject practitioner the submit testimony, counter-documentation and materials to advance his or her interests relevant to the inquiry. The Board of Inquiry shall thereafter, by a simple majority vote, submit their findings and recommendations in writing in the form of a report to the NYSCA Ethics Committee for review. Further, they shall copy their report to the NYSCA Board of Directors and to the accused subject practitioner(s).

D. Review by the NYSCA Ethics Committee

Findings of the Board of Inquiry will be reviewed by the New York State Chiropractic Association Ethics Committee within thirty (30) days of the report of the Board of Inquiry proceedings. Members of the Board of Inquiry will present their findings and recommendations to the Committee. After review of the relevant material, the Ethics Committee by a simple majority vote on the relevant issues, will advance their findings and recommendations to the NYSCA Board of Directors for Board's review at the next available meeting of the Board of Directors.

E. Review by the NYSCA Board of Directors

The NYSCA Board of Directors will review the findings and recommendations of the Ethics and Board of Inquiry at their next available meeting. The subject practitioner may be present the portion of this meeting relevant to the review of the former proceedings and findings. Written proceedings of the Board of Directors review may or may not be taken at the discretion of the Board of Directors. The subject practitioner will be able to rebut testimony, submit relevant documentation and new material to support or justify their actions. The subject practitioner may be represented by counsel at this meeting.

Afterwards the Board shall vote in executive session. Findings and Recommendations will be a result of a simple majority vote of the Board of Directors. Non-adverse actions will be acted upon directly by the Board of Directors (See the definition of non-adverse actions presented elsewhere in this Code) and these actions need not proceed to the next level of review.

Adverse recommendations for action by the Board of Directors will be presented to the House of Delegates for review and vote at the earliest possible time.

F. Review by the NYSCA House of Delegates

The House of Delegates after a review of recommendations and any reports of the Board of Inquiry, NYSCA Ethics Committee and NYSCA Board of Directors shall effect a final determination by a majority vote. The House of Delegates will not be entitled to review of the written/confidential transcripts of the Board of Inquiry Proceedings.

G. Appellate Review

Subject Practitioners may appeal any adverse actions of the New York State Chiropractic Association to the NYSCA Board of Directors upon request and the submission of new documentation supporting the subject's interests. The Board of Directors will be obliged to conduct a hearing at a time and location chosen by the board provided the subject practitioner is given reasonable notice of such a meeting (fifteen [15] days). The Board and subject practitioner(s) will have previous written testimony and transcripts of the Board of Inquiry for reference and review as well as new documentation submitted by the subject practitioner(s).

The Board may permit members of the Board of Inquiry to be present as well as the five original members filing the initial petition for action. The subject may present testimony, character witnesses, documentation and materials to advance their cause. The Board may accept rebuttal of any and all of the foregoing from those they will entertain at these proceedings.

The findings and recommendations of the Board of Directors Appellate Review become final. The Board by simple majority vote, upon submission of new evidence and testimony may reduce an adverse finding imposed by a vote of the NYSCA House of Delegates; or they may continue the findings of the House of Delegates. The Board may not propose or impose more stringent or adverse findings or recommendations than had been voted on by the House of Delegates.


2. Summary or Automatic Disciplinary/Corrective Action

A criminal violation of any of the laws of the State of New York, or a suspension, revocation, or ordered surrender of a practitioners New York State license shall open the offending practitioner or immediate summary and automatic Disciplinary/Corrective action without hearing. The Board of Directors after reviewing the decisions of the courts or state agencies may recommend to the House of Delegates by simple majority vote an adverse action. The House of Delegates may impose such a recommendation by simple majority vote, or may reduce the severity of the adverse action recommended by the Board of Directors. The House of Delegates however, may not impose a more stringent adverse action than recommended by the Board of Directors.


Principle IVH. Adverse Recommendations

A recommendation or decision under the provisions of this code is deemed adverse only when: the subject practitioner is convicted of a criminal violation of the laws of the State of New York or has had his/her license suspended, revoked or ordered surrendered by the State of New York or any other state; or has received multiple non-adverse disciplinary/corrective actions according to Principle IVF above; and it has been alleged and adequately documented by the five members bringing such action; hearings by a duly convened Board of Inquiry have been conducted as prescribed and described herein resulting in an adverse recommendation; the adverse recommendations have been reviewed by the Ethics Committee, followed by the Board of Directors and finally to the House of Delegates for enactment. Adverse actions of the House of Delegates may be appealed to the Board of Directors for review.


Principle IVI. Disciplinary/Corrective Actions of Regular Members

No less than five (5) regular members in good standing may file charges against any other member when sufficient cause exists by filing a written and signed notarized affidavit of such charges with the Secretary of this organization. The affidavit shall detail the allegations against the individual(s) and shall be supported by reference to the specific activities or conduct which constitute the grounds for the request.

Principle IVJ. Removal of Officers, Directors and Delegates

No less than five (5) regular members in good standing may files charges against any officer, director or delegate when sufficient cause exists by filing a written and signed notarized affidavit of such charges with the Secretary of the organization following the procedures outlined further herein.

Principle IVK. The Rights and Responsibilities of the Subject Practitioner(s

Within fourteen (14) days of receipt of a filing of charges by five or more members in the prescribed manner, the NYSCA Secretary through the NYSCA administrative offices will post by registered mail a notice to the subject practitioner of the filed affidavit and request for action together with a notice of the time and place of the hearing. Said notice must be given at least thirty (30) days prior to the hearing. Within sixty (60) days of the posting, a hearing shall be convened before a Board of Inquiry consisting of two (2) official and voting members from the Board of Directors, the association legal counsel [a non-voting legal observer], and three (3) official and voting members from the House of Delegates to be chosen by the President of the organization at his/her discretion. The President shall also select the time and place of the hearing and the Chairman of the Board of Inquiry. No less than five (5) accusers must be present at the hearing.

In the event that the President is the member charged, the Vice President shall exercise the powers of the presidency relative to the selection of the members of the Board of Inquiry and Chairman thereof, and relative to the selection of the time and place of the hearing.

Either side shall have the right to an attorney at his/her/their own expense.

The Board of Inquiry shall first determine whether the charges invoke a procedural, summary or automatic proceeding, and, ultimately whether the charges are credible, warranting adverse or non-adverse action as described above. In the event the Board of Inquiry concludes the charges are not credible enough to warrant action, it may dismiss the charges against the practitioner.

In either case, the Board of Inquiry shall release its findings within sixty (60) days of the convocation of the Board and shall present a written report of its findings and recommendations to the subject practitioner, the Ethics Committee and Board of Directors for subsequent action, if any. The Findings of the Board of Inquiry will be placed in the subject practitioners membership file.


Principle IVL. Indemnification

All Board of Inquiry members, Ethics Committee members, Board of Directors members, staff, legal counsel and House of Delegates members and other individuals engaged in investigations and/or hearings at the written request of the Association are indemnified and defended by the Association against liability arising from any disciplinary/corrective action proceedings.

V. NYSCA Standards of Conduct

Membership in the New York State Chiropractic Association is a privilege and not a right granted to chiropractors in New York State. Out of consideration for the public, and the members of the New York State Chiropractic Association, NYSCA requires that all individuals applying for membership pledge to adhere to the following Standards of Conduct. The code of Standards of Conduct for membership of the New York State Chiropractic Association has been adopted to promote and maintain the highest standards of chiropractic ethics and personal conduct among its members. Adherence to these standards is required for membership in the Association, and serves to assure public and professional confidence in the integrity and service of the Associations members.

As a members of the New York State Chiropractic Association, I pledge myself to:

  1. Maintain complete loyalty to the profession of which I am a member and to aggressively pursue its objectives;

  2. Hold inviolate the confidential relationship between the individual members of my Association and myself, and the confidential information entrusted to me through the Association;

  3. Service all members of my Association impartially, and to provide no special privilege to any individual member, nor to accept special personal compensation from an individual member except with the knowledge and consent of my fellow Association members;

  4. Neither engage in, nor countenance any exploitation of my membership, the New York State Chiropractors Association, or profession;

  5. Recognize and discharge my responsibility and that of my Association to uphold all rules and regulations relating to my Associations activities as may be outlined in the Associations charter;

  6. Exercise and insist on sound chiropractic ethical practice in conducting the affairs of the my practice and the affairs of the Association and profession;

  7. Use only legal and ethical means if I should seek to influence legislation or regulation of professional policies and the policies of the New York State Chiropractic Association;

  8. Refrain from the dissemination of any malicious information concerning other Association members and non-members;

  9. Accept my responsibility for cooperating in every reasonable and proper way with the members of the New York State Chiropractic Association and its staff;

  10. Maintain the highest standards of personal conduct possible.

REFERENCES
  1. American Chiropractic Association. Code of Ethics. Adopted by the ACA House of Delegates, June 21, 1984. American Chiropractic Association, 1701 Clarendon Boulevard, Arlington, Virginia, 22201

  2. American Hospital Association. AHA Patient's Bill of Rights. American Hospital Association, Chicago, Illinois

  3. American Medical Record Association. Confidentiality of Patient Health Information: Position Statement of the American Medical Record Association. American Medical Record Association, Chicago, Illinois, 1985.

  4. Canadian Chiropractic Association. The Canadian Chiropractic Association Code of Ethics. Journal of the CCA June 1984;28(2):250-256.

  5. Joint Commission on Accreditation of Hospitals. Rights and Responsibilities of Patients. In: AMH/87: Accreditation Manual for Hospitals. Joint Commission on Accreditation of Hospitals, 875 North Michigan Avenue, Chicago, IL 60611-1846.

  6. Illinois Prairie State Chiropractic Association. Chiropractic Standards of Practice & Professional Conduct. Adopted by the Illinois Prairie State Chiropractic Association, April 1985. Illinois Prairie State Chiropractic Association, Davenport, Iowa

  7. International Chiropractors Association. International Chiropractors Association Code of Ethics. In: International Chiropractors Association 1985/86 Membership Directory. International Chiropractors Association, 1901 L Street, NW, Suite 800, Washington, DC 20036

  8. Kranz K. Chiropractic Hospital Privileges Protocol. International Chiropractors Association, Washington, DC, 1987.

  9. Medical Staff Bylaws of Oswego Hospital, Oswego, New York

  10. Constitution and Bylaws of the New York State Chiropractic Association. New York State Chiropractic Association, 245 Lark Street, Albany, New York, 12210, January 1989.

  11. The University of the State of New York. Chiropractic Handbook. The University of the State of New York, The State Education Department, Office of the Professions, Division of Professional Licensing Services, Cultural Education Center, Albany, New York 12230