1.1 Use of this code
The Code of conduct for chiropractors seeks to assist and support chiropractors to deliver appropriate, safe and effective services within an ethical framework. Chiropractors have a professional responsibility to be familiar with this code and to apply the guidance it contains.
This code should be read and considered as an entire document and as a document that integrates a number of other codes and standards. Chiropractors need to be aware of, and comply with all standards, guidelines and policies of the Chiropractic Board of Australia (the National Board).1
This code will be used:
- to support individual chiropractors in the task of providing good healthcare and fulfilling their professional roles and to provide a framework to guide professional judgement
- to assist the National Board in its role of protecting the public by setting and maintaining expectations of good practice
- to assist the National Board in evaluating the ethical and professional conduct as well as the performance of practitioners – if ethical, professional conduct or performance varies significantly from this code, chiropractors will be held accountable to explain and justify their decisions and actions, and failure to meet this code may have consequences for registration
- as an additional resource for a range of uses that contribute to enhancing the culture of professionalism in the Australian health system: for example, in chiropractic education; orientation, induction and supervision of students; and by administrators and policy makers, and
- as a guide for the public and consumers of health services about the standards of ethical and professional conduct and professional performance they should expect from registered chiropractors.
Chiropractors must always act in accordance with the law. The code is not a substitute for the provisions of the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law), other relevant legislation and case law. If there is any conflict between the code and the National Law, the law takes precedence.
Chiropractors are subject to a range of general legal obligations and specific obligations under legislation, for example, privacy, child protection and health records. Chiropractors should ensure that they are aware of these obligations and act in accordance with them.
The practice of chiropractic is challenging and rewarding. No code or guidelines can ever encompass every situation or replace the insight and professional judgement of chiropractors. Good practice means using this judgement to try to practise in a way that would meet the standards expected of you by your peers and the community.
While good healthcare respects the rights of patients, this code is not a charter of rights. Health practitioners have critical roles in caring for people who are unwell, assisting people to recover and seeking to ensure people stay well.
This code outlines the National Board’s expectations in relation to the professional and ethical conduct of registered chiropractors but it is not an exhaustive study of professional ethics or an ethics guide. It does not address the clinical practice of the profession. The focus of this code is on good practice and professional behaviour. It is not intended as a mechanism to address disputes between professional colleagues in relation to termination of business relationships and disputes over clients.
Chiropractors should acknowledge and comply with supplementary guidance published by the National Board from time to time on specific issues.
1These can be found on the National Board’s website and as appendixes to this code.
1.2 Professional values and qualities
While individual health practitioners have their own personal beliefs and values, there are certain professional values on which all health practitioners are expected to base their practice. These professional values apply to the practitioners conduct regardless of the setting, including in person and electronically, e.g. in the social media.
Health practitioners have a duty to make the care of patients their first concern and to practise safely and effectively.
Health practitioners must be ethical and trustworthy. Patients trust health practitioners because they believe that, in addition to being competent, health practitioners will not take advantage of them and will display qualities such as integrity, truthfulness, dependability and compassion. Patients also rely on health practitioners to protect their confidentiality.
Health practitioners have a responsibility to protect and promote the health of individuals and the community.
Good practice is centred on patients. It involves health practitioners understanding that each patient is unique and working in partnership with patients, adapting what they do to address the needs and reasonable expectations of each person. This includes cultural awareness: being aware of their own culture and beliefs, and respectful of the beliefs and cultures of others, and recognising that these cultural differences may affect the health practitioner–patient relationship and on the delivery of services. It also includes being aware that differences such as gender, sexuality, age, belief systems and other anti-discrimination grounds may influence care needs and avoiding discrimination on the basis of these differences.
Effective communication in all forms underpins every aspect of good practice.
Professionalism embodies all the qualities described here and includes self-awareness and self-reflection. Health practitioners are expected to reflect regularly on whether they are practising effectively, on what is happening in their relationships with patients and colleagues, and on their own health and wellbeing. They have a duty to keep their skills and knowledge up to date, refine and develop their clinical judgement as they gain experience, and contribute to their profession.
All practitioners have a responsibility to recognise and work within the limits of their competence, scope and areas of practice. Areas of practice vary according to different roles; for example, health practitioners, education providers, researchers and managers will all have quite different competencies and scopes of practice.
Health practitioners should be committed to safety and quality in healthcare.2
2See the Australian Commission on Safety and Quality in Health Care.
1.3 Australia and Australian healthcare
Australia is culturally and linguistically diverse. Health practitioners in Australia reflect the cultural diversity and this enhances our healthcare system and strengthens the health profession.
There are many ways to practice a health profession in Australia. Practitioners have critical roles in caring for people who are unwell, assisting people to recover and seeking to keep people well. This code focuses on these roles. For practitioners with roles that involve little or no contact with patients, not all of this code may be relevant, but the underpinning principles will still apply.
1.4 Substitute decision-makers
There are several conditions or situations in which patients may have limited competence or capacity to make independent decisions about their healthcare; for example, people with dementia or acute conditions that temporarily affect competence, and children or young people, depending on their age and capacity (see Section 3.5 Informed consent).
In this code, reference to the term ‘patients’ also includes substitute decision-makers for patients who do not have the capacity to make their own decisions. These can be parents or a legally appointed decision-maker. If in doubt, seek advice from the relevant guardianship authority.