Baxter Hickey – 117286
November 23, 2015
1
Professionalism and Ethics in Chiropractic
Professionals are factions within society that profess or openly claim to possess unique
skills that society does not (1). When examining a profession that one is entering, it is important
to consider professional identity, professional privilege, and public trust and what it means to
that person. Furthermore, it is important to distinguish the difference between professionalism
and ethics, as well as morals and ethics.
Professional identity can be defined as one’s expert self-concept based on characteristic
attributes, beliefs, values, motives, and experiences (1). In my opinion, professional identity
includes appropriate behavior with patients, arriving on time for all patient visits, and dressing
according to your role. These qualities are important to have when entering the professional
field. Encompassing the true essence of a professional identity is just as important as being a part
of the profession itself.
Professional privilege within the chiropractic profession is acquired through extensive
educational training. As a result, an individual trained in chiropractic care has specific
opportunities within the healthcare system (1). Expanding upon this, chiropractors are given the
privilege of performing spinal manipulative therapy (SMT) as a main form of treatment for
musculoskeletal ailments (1). Chiropractors are expected to provide all patients with the
necessary and appropriate treatment. Appropriate treatment involves both beneficence and nonmalfeasance. Beneficence is defined as the principle of doing as much good as one can while
non-malfeasance, or first, do no harm, is the principle of inflicting the least harm possible to
reach a beneficial outcome (1). Although these terms might slightly differ in regards to how an
individual might go about care, they provide similar outcomes. By having a strong sense of
professional identity, I believe that it will provide me with a strong sense of pride as a
chiropractor.
Social contract is a term that describes the connection that society has with a medical
profession (2). There is a general level of public trust that is expected by all patients seeing a
chiropractor. These expectations might include patients understanding that when they are treated
by a chiropractor, they will be treated appropriately and their health information will remain
confidential (2). As an end result, there is a strong sense of public trust and patients would be
able to understand why their particular treatment, although potentially uncomfortable, is well
worth the risk and discomfort (1). Once again, we can relate this back to the idea of beneficence
and non-malfeasance. It is in the public’s interest to ensure all potential risks taken by the
chiropractor are for the greater good of the patient (1). For me, this is important in terms of
patient treatment. Being able to eventually have the privilege and accountability to treat my
future patients appropriately and with compassion will provide me with a sense of fulfillment.
Professionalism includes qualities of self-promotion, evidence-based medical care, and
inter- and intraprofessional interaction, and the overall competence of skill expected of a
professional (1). Professionalism, from a teaching and educational perspective, focuses on setting
expectations for success, providing fruitful learning experiences, and evaluating outcomes of
different treatments (3). Ethics involves the moral principles that govern a person or group of
people within a profession (1). Ethical behavior within a profession is subject to different faucets
of accountability. These include following normative laws within society, monitoring and
assessing the activities and actions of the doctor during patient treatment, and being held
accountable for all actions taken (1). This provides me with a sense of confidence that all
clinicians are being held responsible for their actions, with potential reprimands if an
inappropriate action occurs. As a result, chiropractic has progressively been able to obtain a
stronger sense of professionalism and respect within the healthcare profession.
Baxter Hickey – 117286
November 23, 2015
2
Professionalism and Ethics in Chiropractic
Morals and ethics are two terms that are often grouped together to mean the same thing.
Both provide an appraisal of actions or behaviours, both refer to definitive standards, both are
altruistic, and both involve universal principles that should be judged uniformly within that
profession (1). One difference between the two is that morals refer to specific actions and
judgments, while ethics are the inherent rules by which conclusions are made (1). Upon
completing the Doctor of Chiropractic program, it will be my responsibility to be both a moral
and ethical chiropractor. This might include not providing unnecessary x-ray imaging to every
patient or performing SMT on a patient who does not require it in order to further my own
monetary gain. This follows the concept of not placing your own self-interests above those of the
patient’s or society as a whole (1).
In conclusion, being in a professional occupation, such as chiropractic, comes with many
amazing opportunities and privileges, as well as serious responsibilities to society. Both morals
and ethics will guide our professional behaviors in practice and allow us to uphold to high
standards of professionalism.
Baxter Hickey – 117286
November 23, 2015
3
Professionalism and Ethics in Chiropractic
References:
1. Mootz RD, Coulter I, Schultz GD. Professionalism and ethics in chiropractic. In:
Haldeman S, editor. Principles and Practice of Chiropractic. 3rd ed. New York: McGrawHill Medical; 2005.
2. Cruess SR, Cruess RL. Professionalism and medicine’s social contract with society.
Virtual Mentor. 2004 Apr 16:6(4).
3. Stern DT, Papadakis M. The developing physician – becoming a professional. N Engl J
Med 2006 Oct 26:3555(17):1794-9.