Code of ethics :
The Canadian Society for Traditional Osteopathy hereinafter referred to as the Society.
TABLE OF CONTENTS
Chap. 2 - Duties and obligation toward the patient
Chap. 3 - Duties and obligations toward osteopathy.
Chap. 4 - Duties and obligations related to publicity and advertising.
Chap. 5 - Duties and obligations related to file and consulting office keeping. Someone will have to read the PIPEDA legislation before putting this on the website in Ontario.
Chapter 1: General duties and obligations to the public.
1.1 The member of the Society must make the practice of osteopathy progress by encouraging education measures and information in his practicing domain.
1.2 The member of the Society that exposes osteopathic opinions and/or information in public by any media means must do so with objectivity, moderation, respect and dignity.
1.3 The member of the Society must not, directly or indirectly, publish or spread publicly reports or comments known to him to be false or that are manifestly false towards osteopathy, a patient, another member or the Register.
1.4 The member of the Society must support the authority and the goals of the Society.
Chapter 2: Duties and obligations towards the patient.
2.1 General clauses.
2.1.1 The member of the Society has the duty, in the execution of his osteopathic practice, to give priority to the health and general well-being of his patients.
2.1.2 The member of the Society must fulfill his osteopathic practice according to the principles taught, with dignity, integrity, availability, responsibility, disinterestedness and confidentiality.
2.1.3 Before accepting to undertake or continue a therapy, the member of the Society must consider the limits of his aptitudes, of his knowledge and of the means at his reach. He must not, in particular, undertake or pursue a therapy for which he is not sufficiently prepared without getting the necessary help.
2.1.4 The member of the Society must seek to establish a mutual relation of trust with the patient.
2.1.5 The member of the Society must refrain from intervening in the patient’s private affairs or on matters that do not come under the competence generally known to osteopathy.
2.1.6 The member of the Society must always acknowledge the right of the patient to interrupt his therapy to consult another member of the Society or any other competent person.
2.1.7 To the best of his knowledge, the member of the Society has the duty to inform, to direct and/or to refer the patient towards any other type of therapeutic intervention that are not relevant to his competence and that he estimate necessary to the health and well-being of his patient.
2.1.8 Before any therapeutic intervention, the member of the Society must ascertain that the patient is not in a state of emergency or important pathology that necessitate other types of interventions to protect his integrity. According to the case, the member must refer to competent services, which would not prevent adjuvant treatments.
2.2.1 The member of the Society must fulfil his therapeutic obligations with integrity. Without limiting the generalities of the followings, the member of the Society must not :
a) directly or indirectly deceive his patient, acting by himself or with the help of others. Among others, he must avoid all false representation regarding his level of competence, the effectiveness of his services and of those generally carried out by other members of the Society.
b) deliver to anyone and for any purpose a certificate, a declaration, a report or any other document relative to the health of a patient that he knows to contain false information.
c) in the context of a given therapeutic intervention, wrongfully seek, obtain or grant a profit, a commission, a discount or any unjustified material benefit for him, his patient or any other person.
d) fulfill or multiply, without justification, contradictory or incomplete therapeutic acts.
e) conceal to the patient any risk inherent to the therapeutic consultation.
f) conceal to the patient any prejudicial mistake made during a therapeutic consultation.
g) give the patient a voluntarily or manifestly erroneous evaluation of his therapeutic needs.
h) fulfill or multiply, without justification, therapeutic acts that are inappropriate or disproportionate for the needs of the patient.
i) guarantee, directly or indirectly, the recovery of a patient or even to claim responsibility for it.
j) abuse, in the exercise of his duties, of the inexperience, the ignorance, the naivety or the bad health state of his patient in order to gain any kind of advantage or benefit.
k) claim from a patient any amount of money for a therapeutic act while knowing that the cost is also assumed by a third party.
l) maintain any physical, mental or emotional promiscuity with his patient.
m) voice an opinion on the general state of health of a patient without any pathological investigation by a legally recognize health professional.
2.3 Receptiveness and diligence.
2.3.1 The member of the Society must manifest reasonable receptiveness and diligence in the exercise of his duties.
2.3.2 The member of the Society must manifest reasonable receptiveness and diligence in the exercise of his duties.
2.3.3 The member of the Society must not, except for fair and reasonable reasons, stop prematurely any therapy on a patient. Notably, fair and reasonable reasons can be :
a) the lost of trust of the patient;
b) the fact of being deceived by the patient or his refusal to collaborate;
c) incitement by the patient to accomplish illegal, unjust, immoral or fraudulent acts;
d) the fact of being in conflict of interests or in such a context that his independence as a therapist could be questioned
e) incompatibility of character;
f) refusal by the patient to honour his obligations.
2.3.4 When the member of the Society prematurely interrupts any therapy on a patient, he must, as much as possible, make sure that the patient takes necessary arrangements to avoid serious and predictable harm.
2.4.1 The member of the Society must not in any way, in the exercise of his duties, evade or attempt to evade his personal civil responsibility toward his patient.
2.5 Independence and impartiality.
2.5.1 The member of the Society must protect at all time his independence of practice and avoid all situations where he would find himself in conflict of interest, notably when the opposing interests are such that he could be drawn to prefer some of them to those of the treated patient, or that his judgment, his integrity and his loyalty toward the latter could be affected
2.5.2 The member of the Society must not in any case take into account or let himself be influenced by a patient or any third party in what concern the exercise of his osteopathic duties.
2.5.3 As soon as he finds himself in a situation of conflict of interest or in a situation that could lead to believe so, the member of the Society must advise his patient and request of him the authorisation to pursue the treatment.
2.6 2.6 Confidentiality
2.6.1 The member of the Society must keep secret what has come to his knowledge in the exercise of his duties: he must, notably, refrain from undertaking indiscreet conversation about his patients or about the services that are render to them or to reveal that a person has resorted to his services unless the nature of the case requires it and under the consent of the patient.
2.6.2 The member of the Society must take reasonable means toward his employees and the personnel surrounding him to preserve the professional secrecy.
2.6.3 The member of the Society can only be released from professional secrecy by the written authorisation of the patient or when law orders it.
2.6.4 When a member of the Society asks a patient to reveal information of a confidential nature or when he allows for such information to be reveal to him, he must assure himself that the patient is fully aware of the goal of the interview and of the various ways this information can be used.
2.6.5 The member of the Society must not use confidential information to the detriment of a patient and/or as a way to obtain directly or indirectly an advantage or benefit for himself or others.
2.7 Determination and payments of fees.
2.7.1 The member of the Society must ascertain that his client is informed of the approximate and expected cost of his services.
2.7.2 The member of the Society must ask and accept just and reasonable fees.
2.7.3 The fees are just and reasonable if they are justified by the circumstances and proportionate to the given treatments. The member of the Society must notably take into account the following factors to determine his fees :
a) his experience;
b) the time devoted to the treatment;
c) the difficulty of the given treatment;
d) the provision of unusual treatments or of treatments asking for a particular competence or promptness.
2.7.4 The member of the Society must give his patient all necessary explanation to the understanding of his fee statement and of the modes of payments.
2.7.5 The member of the Society must refrain from asking a payment in advance for his services.
2.7.6 The member of the Society must refrain from claiming fees for treatments and/or services that have not been given or that have been falsely described.
2.7.7 The member of the Society can claim a just and reasonable compensation from the patient that has not showed up to an appointment without cancelling, therefore causing a net lost of time considering the particular length of the periods reserved for this type of intervention, conditional to a prior agreement with the patient.
Chapter 3: Duties and obligations toward osteopathy.
3.1.1 It is incompatible with the exercise of osteopathy for a member of the Society to use his name, his practice or his osteopath’s status for commercial uses other than the exercise of osteopathy.
3.2 Derogatory acts.
3.2.1 It is derogatory to the dignity of the practice of osteopathy for a member of the Society :
a) to guarantee, directly or indirectly, expressly or implicitly, the recovery from an illness or other pathology;
b) to use his osteopathic knowledge out of the field of his professional competence;
c) to fulfill osteopathic acts conflicting with generally recognize osteopathic principles;
d) to refuse or neglect, without justification, to answer the demands of the Society;
e) in a reasonable delay, not to inform the Society of a violation of the code of ethics committed to his personal knowledge by a peer;
f) to communicate with the plaintiff, without a prior written permission of the Society, when he is informed of a complaint on his conduct or his competence or when he has received a notification of a complaint against him;
g) not to inform immediately the Society when he knows of any reason why a candidate should not be admitted to the Society;
h) to voice publicly and without justification, directly or indirectly, reservations or criticism on osteopathy or its practice;
i) to use, to practice, to transmit or communicate the terms, techniques, approaches, methods of evaluation and methods of therapeutic intervention proper to osteopathy under other name or designation or to omit to mention there osteopathic origins.
3.3 Practice of osteopathy.
3.3.1 The member of the Society must practice in accordance with generally recognize osteopathic standards. To do so, it is recommended to keep up to date and to improve knowledge by a minimum of thirty (30) hours of courses per 2 year in a teaching institution duly recognize by the Society.
3.3.2 The member of the Society must elaborate his evaluation of prescribe therapeutic intervention with great care, using the most appropriate methods.
3.3.3 The member of the Society must, as much as possible, ascertain that the best therapeutic intervention, appropriate for the situation of the patient, be given to the latter. If he finds himself incapable of performing the intervention alone in a suitable way, the member must seek collaboration of a peer or turn the patient to a group of practitioners capable of performing the intervention.
3.3.4 The member of the Society must show extreme caution when he considers worthwhile for the patient to us means of evaluation and/or intervention that are not well known and/or not well proven by osteopathy and recognized professional circles.
3.3.5 The member of the Society must refrain from practicing under circumstances or states likely to compromise the quality of his services or the dignity of his practice.
3.3.6 The member of the Society must practice a therapeutic intervention only if it is necessary to the well-being and/or the condition of the patient.
3.3.7 The member of the Society must refuse to collaborate or to participate to any therapeutic intervention that would go against what he considers to be the health and the well-being of the patient.
3.3.8 The member of the Society must make sure that the patient or his representative or people whom consent might be required by law have received necessary explanations regarding the nature, the purpose and the possible consequences of the therapeutic evaluation or intervention that the member of the Society is about to perform.
3.3.9 The member of the Society must, before undertaking a therapeutic evaluation or intervention, obtain a free and enlightened authorisation from the patient, his representative or someone appointed by law.
3.3.10 The member of the Society who evaluates a patient must :
a) reveal to the latter the purpose of the intervention and let him know all inherent risk;
b) refrain from obtaining or making any disclosures or interpretations not relevant to his intervention to the patient;
c) refrain, unless it is justify, from comments or actions likely to diminish the trust of the latter toward his therapist and/or the science he practice;
d) if relevant, pass on a professional report to a health professional asking for a therapeutic evaluation of a patient unless the latter disagree.
3.3.11 In the scope of his osteopathic practice, the member of the Society can not entrust anyone who is not a member of the Society with the care of providing acts that falls within the exercise of osteopathy.
3.3.12 The member of the Society can not in any case use the name and the practice of osteopathy to purposes other than those of osteopathy as an honest and independent therapeutic intervention unit, dissociated and defined from other types of physical or psycho-physical approaches.
3.3.13 The member of the Society must, to the best of his abilities, help to the development and diffusion of osteopathy by exchange of knowledge and experience with his peers and students in training, participation to courses, scientific conferences, training courses and symposiums.
3.4 Interactions with peers
3.4.1 The member of the Society who faces a doubt on a therapeutic evaluation or intervention must not hesitate to consult a peer.
3.4.2 The member of the Society must accept, grant priority attention and put forward all possible means to answer adequately in a reasonable time limit to a consultation request of a peer.
3.4.3 The member of the Society must give to the referred peer all information considered helpful to the health and well-being of the patient considering the rules of professional confidentiality.
3.4.4 The member of the Society, upon request of consultation by a peer, must hastily give the results of his consultation and the recommendations that he considers appropriate.
3.4.5 The member of the Society consulted by a peer must not take charge of the patient without the authorization of the first therapist and of the aforementioned patient.
3.4.6 However, the member of the Society consulted by a peer can take charge of a patient upon formal and enlightened request of the latter.
3.4.7 The member of the Society who provides care for a patient in the absence of his therapist must :
a) hand over to the latter all helpful information to continue the therapeutic intervention as soon as he returns;
b) refrain from using any intervention or means in view to take over the charge of the patient.
3.4.8 The member of the Society must, when he refers a patient to a peer, give to the latter all the information he has that can be useful to the evaluation and to all the therapeutic intervention that can be given to the patient.
3.4.9 The member of the Society who is asked to collaborate with a peer must preserve his independence in his osteopathic practice. If he is asked to perform a task contrary to his conscience or his principles, he can request to be relieved. In a contentious or doubtful case, he can seek advice from the Society.
3.4.10 The member of the Society must be loyal and honest toward his peers, his profession, osteopathy and its institutions. He must not deceive the good faith of a peer or make himself guilty of breach of trust or dishonest behaviour. He must not, notably, claim credit for the work of a peer. He must refrain from denigrating, openly hold or put in doubt the acts, the abilities or the practice of a peer or his science with, for only excuse, his own personal convictions.
3.5 Interactions with the other members of the Société
3.5.1 The member of the Society must answer as soon as possible to all correspondence or request coming from the Society.
3.5.2 The member of the Society must, after receiving a reasonable notice, give access to the Society to his consulting office, his files and his advertising in order to verify their conformity.
3.5.3 The member of the Society must, as soon as possible, report to the Society any member that he believes unfitted to practice or that practices with incompetence, dishonesty or in violation of the code of ethics.
3.5.4 The member of the Society must refrain from accepting or offering any advantage or benefits for contributing or for having contributed to any decision from the Register.
3.5.5 The member of the Society must support the authority and the objectives of the Society.
3.5.6 It is a duty to the member the Society, to the best of his abilities, to take part on the Disciplinary committee when asked to do so.
Chapter 4: Duties and obligations related to publicity and advertising
4.1 General dispositions.
No member of the Society can make, or permit that be made, by any mean, false, misleading or incomplete advertising.
A member of the Society can not claim particular qualities or skills, notably concerning his level of competence or the extent or effectiveness of his services unless he is able to justify it.
No member of the Society can, in his advertising, use or permit the use of support or gratitude testimony concerning him.
4.2 Business card and stationary.
4.2.1 The member of the Society can put down on his business card and any other kind of stationary :
a) his name, followed by the name of his associates and the name under which he practices in the cases where law permits him to practice under a name that differs from his;
b) his academic degrees and professional affiliations followed by the acronym attesting his osteopathic competence;
c) the address of his practice, his telephone and fax number and his business hours;
d) the graphic symbol of the Society;
e) if need be, the name of the establishment where he works, the name of his colleagues and/or associates.
4.3 Information and printed media.
4.3.1 The member of the Society can publish or allow to be published in newspapers, magazines, periodicals, directories or other printed media, advertisement containing all or parts of what is mentioned in the preceding article.
4.3.2 On the occasion of a change of associates, of the opening of his business place, of his arrival in an existing business place, of his first inscription in the Register of the Society, of a nomination to an appointment related to the exercise of his practice or in matters that concern the following b) paragraph or of a change of address, the member of the Society can :
a) publish his photograph and some biographic notes in newspapers, magazines, periodicals or other printed media;
b) distribute to interested organizations a brochure, a card or a letter mentioning all or parts of what is indicated in article 4.2.1.
4.3.3 The member of the Society can use a public media to state, with respect to the present Code, his opinion on a subject related to the exercise of his practice and let his position be known.
4.4 Use of Graphics.
4.4.1 When an official graphic symbol of the Society is reproduced for advertising, it must be official, reproduced in full and not give the impression that it is an advertisement from the Society.
4.4.2 The member of the Society must ascertain that the use of the symbol is in accordance to the present directions.
Duties and obligations related to file and consulting office keeping. Someone will have to read the PIPEDA legislation before putting this on the website in Ontario
5.1 General dispositions.
5.1.1 In the present regulation, unless the context indicates a different meaning, “consulting office” is understood to be the place where the member receives a patient in private for osteopathic consultation.
5.1.2 Nothing in the present regulation must be interpreted as excluding the use of any other technique for the consultation and the file keeping of a member of the Register.
5.2 Keeping of consulting offices.
5.2.1 The member of the Society must lay out his consulting office in such a way that conversations between him, his personnel, and the patient can not be heard by others.
The layout of the different premises of the office must assure the intimacy of the patients.
5.2.2 The member of the Society must provide for his patients a waiting room near his consulting office.
5.2.3 The consulting office must show at all time the salubriousness and the hygiene proper to the kind of professional exercise of the member of the Register, notably :
a) the premises must be sufficiently well-lit , well-ventilated and heated;
b) a sink must be installed in or near the consulting office;
c) a bathroom must be accessible to the clientele.
5.2.4 The layout of the consulting office must be free of clutter and the member of the Society must assure its maintenance.
5.2.5 The member of the Society must ascertain when it is the case, that his employees respect the keeping of the office in accordance with the present regulation.
5.2.6 The member of the Society must write daily in an agenda, the names and given names of the patients he sees in his office. This agenda must be kept for a period of five (5) years.
5.3 Files keeping.
5.3.1 The member of the Society must put together an osteopathic file for anyone who consults him.
5.3.2 The file should contain a clear identification of the patient :
a) family name, given name, sex, date of birth, address, telephone number;
b) date of the opening of the file;
c) the diagnostic(s) made by previous physician and/or consulting professional;
d) a global evaluation of the patient: birth, personal, family, medical, chirurgical, traumatic and vaccination history;
e) a description of the given treatments, the date they were given and their relation to the case history listed in d).
5.3.3 For each patient, the member of the Society should write the history of the actual problem and of its antecedents, including :
a) a global evaluation of the patient including an impression of his general state;
b) an osteopathic evaluation of the patient;
c) relevant tests results (Rx, laboratory) if needs arise;
d) the draw up of the planned treatment.
5.3.4 For each meeting with the patient, the member of the Society must write :
a) the date;
b) the problem re-evaluation;
c) the work done;
d) the recommendations made to the patient;
e) the work foreseen for the next meetings;
5.3.5 The file can also include annotations, correspondence, other documents related to the rendered services and legal authorisations if needs arise.
5.3.6 For all document removed from the file, the member of the Society must keep a photocopy in the file, note the date and reason of the withdrawal.
5.4 Files accessibility.
5.4.1 The files must be kept in a room or a piece of furniture to which the public has no free access or that can be locked with a key or otherwise.
5.4.2 The files must be kept for at least five (5) years starting at the date of the last insertion to the file.
Code of ethics of The Canadian Society for Traditional Osteopathy hereinafter referred to as the Society.