The shared Code of conduct (the code) has been revised as part of a scheduled review following public consultation.
The code is an important part of the National Boards’ regulatory framework and helps to keep the public safe by outlining the National Boards’ expectations of professional behaviour and conduct for registered health practitioners.
Registered health practitioners have a responsibility to be familiar with and apply their relevant code.
An advance copy of the code is available to help practitioners and the public understand the changes in the revised code.
The revised code comes into effect on 29 June 2022.
Read the revised shared Code of conduct
This following information has been developed to help health practitioners understand and apply the revised code.
The 15 National Boards regulating registered health practitioners in Australia are responsible for registering practitioners and students (except for in psychology, which has provisional psychologists), setting the standards that practitioners must meet, and managing complaints and concerns (notifications) about the health, conduct or performance of practitioners.
The Australian Health Practitioner Regulation Agency (Ahpra) works in partnership with the National Boards to implement the National Registration and Accreditation Scheme, under the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).
The core role of the National Boards and Ahpra is to protect the public.
Code of conduct
This code has been developed by most National Boards under section 39 of the National Law.
This code is substantially based on the Code of conduct for registered health practitioners adopted by a number of the National Boards as part of the National Registration and Accreditation Scheme (the National Scheme) with further inclusions specifically for the chiropractic profession.
This code seeks to assist and support chiropractors to deliver safe and effective health services within an ethical framework. All health practitioners have a duty to make the care of patients their first concern and to practise safely and effectively. Maintaining a high level of professional competence and conduct is essential for providing good care.
This code is a guide to the expected standards of behaviour of chiropractors in relation to:
Making decisions about healthcare is the shared responsibility of the health practitioner and the patient (or their representative).
Practitioners must practise in an evidence-based and patient-centred manner so that they provide the best possible healthcare for their patients.
An important part of the health practitioner–patient relationship is effective communication. Relationships based on openness, trust and good communication (in person, written and electronic) will enable health practitioners to work in partnership with their patients.
Health practitioners have ethical and legal obligations to protect the privacy of people requiring and receiving care. Patients have a right to expect that health practitioners and their staff will hold information about them in confidence, unless information is required to be released by law or due to public interest considerations.
Health practitioners need to obtain informed consent for the care that they provide to their patients. Caring for children and young people brings additional responsibilities for health practitioners.
Good practice involves genuine efforts to understand the cultural needs and contexts of different patients to obtain good health outcomes. Health practitioners need to be aware that some patients have additional needs and modify their approach appropriately.
When adverse events occur, health practitioners have a responsibility to be open and honest in communication with patients and in reviewing what happened.
In some circumstances, the relationship between a health practitioner and a patient may become ineffective or compromised, and may need to end.
Good relationships with colleagues and other health practitioners strengthen the health practitioner– patient relationship and enhance care.
Health practitioners have a responsibility to contribute to the effectiveness and efficacy of the healthcare system.
Minimising risk to patients is a fundamental component of practice. Good practice involves understanding and applying the key principles of risk minimisation and management to practice.
Health practitioners maintaining and developing their knowledge, skills and professional behaviour are core aspects of good practice.
Teaching, supervising and mentoring health practitioners and students is important for their development and for the care of patients. It is part of good practice to contribute to these activities, and provide support, assessment, feedback and supervision for colleagues, health practitioners-in-training and students.
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:
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.
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.
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.
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.
The practice of any health profession has both clinical and non-clinical aspects. Certain levels of professional values and behaviours are required of all chiropractors regardless of their practice. For those in clinical practice, providing good care to patients is their primary concern.
Providing good care includes:
Maintaining a high level of professional competence and conduct is essential for the good practice of the profession. Good practice involves:
Making decisions about healthcare is the shared responsibility of the chiropractor and the patient. Patients may wish to involve their family, carer or others. (See Section 1.4 Substitute decision-makers).
A chiropractor’s decision about access to care needs to be free from bias and discrimination.
Good practice involves:
Treating patients in emergencies (whether within practice or in a first aid situation) requires chiropractors to consider a range of issues in addition to the provision of best care. Good practice involves offering assistance in an emergency that takes account of the chiropractor’s own safety, skills, the availability of other options and the impact on any other patients under the chiropractor’s care, and continuing to provide that assistance until services are no longer required.
Relationships based on respect, trust and good communication will enable chiropractors to work in partnership with patients.
A good partnership between a chiropractor and the person they are caring for requires high standards of personal conduct. This involves the chiropractor:
A good partnership between the chiropractor and the person they are caring for also involves the patient contributing to the effective therapeutic partnership by:
An important part of the chiropractor–patient relationship is effective communication. This involves
Chiropractors have ethical and legal obligations to protect the privacy of people requiring and receiving care. Patients have a right to expect that chiropractors and their staff will hold information about them in confidence, unless release of information is required by law or public interest considerations. Good practice involves:
Informed consent is a person’s voluntary decision about healthcare that is made with knowledge and understanding of the benefits and risks involved. A useful guide to the information that chiropractors need to give to patients is available in the National Health and Medical Research Council (NHMRC) publication General guidelines for medical practitioners in providing information to patients.3
The NHMRC guidelines cover the information that chiropractors should provide about their proposed management or approach, including the need to provide more information where the risk of harm is greater and likely to be more serious, and advice about how to present information. Good practice involves:
3Available on the NHMRC website under Guidelines.
Informed consent about healthcare also includes informed consent about financial matters.
Good practice involves a discussion about fees in a manner appropriate to the relationship and should include discussion about the cost of all required services and a general agreement as to the level of treatment/care to be provided.
When choosing to use financial agreements, good practice involves:
Caring for children and young people brings additional responsibilities for chiropractors. Mandatory reporting of child abuse and neglect is legislated in all states and territories in Australia. Practitioners have a responsibility to be aware of, and comply with, any mandatory reporting requirements in their state or territory. This section should be read in close conjunction with Sections 2.1 and 2.2: Good practice.
Good practice with children and young people involves:
Awareness of the cultural diversity that exists and how this affects the delivery of healthcare is an important consideration for health practitioners. Good practice involves genuine efforts to understand the cultural needs and contexts of different patients to obtain good health outcomes. This includes:
Some patients (including those with impaired decision-making capacity) have additional needs. Good practice in managing the care of these patients includes:
When adverse events occur, chiropractors have a responsibility to be open and honest in communication with the patient and in reviewing what happened and reporting appropriately (also see Section 7.2(a)). When something goes wrong, good practice involves:
Patients who are not satisfied have a right to complain about their care. When a complaint is made, or a formal notification is received by the National Board, good practice involves:
Practitioners have a vital role in assisting the community to deal with the reality of death and its consequences. In caring for patients or clients towards the end of their life, good practice involves:
In some circumstances, the relationship between the chiropractor and a patient may become ineffective or compromised, and may need to end. Good practice involves ensuring that the patient is adequately informed of the decision and facilitating arrangements for the continuing care of the patient, including passing on relevant clinical information.
Good practice includes chiropractors recognising the potential conflicts, risks and complexities of providing care to those with whom they have a close relationship, e.g. close friends, work colleagues and family members. In some cases, this can be inappropriate because of a lack of objectivity, possible discontinuity of care and risks to the practitioner or patient. When a practitioner chooses to provide care to those in a close relationship, good practice requires that:
Where chiropractors are considering treating multiple patients simultaneously in class or group work, or more than one individual patient at the same time, they should consider whether this mode of treatment/care is appropriate for the patients involved.
Chiropractors should be especially conscious of the privacy and confidentiality of their patients in such environments (see also Section 3.4 Confidentiality and privacy).
When closing or relocating a practice, good practice involves:
Chiropractors use varying diagnostic and therapeutic tools, tests and procedures in the assessment and management of patients. Ensuring a high level of competence and skill in using particular diagnostic or therapeutic modalities is essential to good care.
Chiropractors should ensure that they are appropriately trained, skilled and qualified to practise any modalities used. In addition, chiropractors should be aware of any relevant local, state or territory laws that may affect the practice of different modalities.
Good care is enhanced when there is mutual respect and clear communication between all health professionals. Good practice involves:
Delegation involves a chiropractor asking another person or member of staff to provide care on behalf of the delegating chiropractor while that chiropractor retains overall responsibility for the care of the patient.
Referral involves a chiropractor sending a patient to obtain an opinion or treatment/care from another practitioner. Referral usually involves the transfer (in part) of responsibility for the care of the patient, usually for a defined time and a particular purpose, such as care that is outside the referring chiropractor’s expertise or scope of practice.
Handover is the process of transferring all responsibility to another practitioner.
Many chiropractors work closely with a wide range of other practitioners, with benefits for patient care. Effective collaboration is a fundamental aspect of good practice when working with other practitioners.
The care of patients is improved when there is mutual respect and clear communication, as well as an understanding of the responsibilities, capacities, constraints and ethical codes of each other’s health professions.
Working with other practitioners does not alter a chiropractor’s personal accountability for professional conduct and the care provided. Good practice involves:
It may be necessary at times in practice to delegate some clinical activities to staff, students or assistants. When delegating clinical activities, chiropractors have a responsibility to ensure that the person to whom they are delegating can safely and competently perform the delegated activity. When delegating clinical activities to staff, chiropractic students (not undertaking a supervised external clinical placement), assistants or other people, good practice involves:
Note: Section 5.4 does not apply to registered chiropractic students undertaking a supervised external clinical placement as a part of a National Board-approved program of study.
Chiropractors have a responsibility to contribute to the effectiveness and efficiency of the healthcare system.
It is important to use healthcare resources wisely. Good practice involves:
There are significant disparities in the health status of different groups in the Australian community. These disparities result from social, cultural, geographic, health-related and other factors. Good practice involves using expertise and influence to protect and advance the health and wellbeing of individual patients, communities and populations.
Chiropractors have a responsibility to promote the health of the community through disease prevention and control, education and, where relevant, screening.
On any public health matter, practitioners are obliged to provide balanced, unbiased and evidence-based information in order to enable members of the public to make informed health decisions. When called upon to provide advice that is beyond their usual area of practice, chiropractors should seek to refer those patients to another practitioner who possess such expertise.
Risk is inherent in healthcare. Minimising risk to patients is an important component of practice. Good practice involves understanding and applying the key principles of risk minimisation and management in practice.
Good practice in relation to risk management involves:
4Available at the Australian Commission on Safety and Quality in Health Care website under Publications.
The welfare of patients may be put at risk if a chiropractor is performing poorly. Good practice involves:
5Refer to the National Board’s Guidelines for mandatory notifications.
Maintaining and developing knowledge, skills and professional behaviour are core aspects of good practice. This requires self-reflection and participation in relevant professional development, practice improvement and performance-appraisal processes to continually develop professional capabilities. These activities must continue through a chiropractor’s working life as science and technology develop and society changes.
Development of knowledge, skills and professional behaviour must continue throughout a chiropractor’s working life. The National Law requires that chiropractors (and all of the regulated health professions) keep their knowledge and skills up to date through CPD to ensure that chiropractors can continue to work within their competence and scope of practice. Refer to the National Board’s registration standard and guidelines on CPD.6
6Available on the Chiropractic Board of Australia website under Registration standards and Codes and guidelines.
In professional life, chiropractors must display a standard of behaviour that warrants the trust and respect of the community. Good practice involves:
Professional boundaries allow a practitioner and a patient to engage safely in a therapeutic relationship.
Professional boundaries refers to the clear separation that should exist between a chiropractor’s professional conduct that is aimed at meeting the health needs of patients, and a chiropractor’s own personal views, feelings and relationships that are not relevant to the therapeutic relationship.
Professional boundaries are integral to a good chiropractor-patient relationship. They promote good care for patients and protect both parties. Good practice involves:
Chiropractors have statutory responsibility under the National Law to report matters to the National Boards (refer to the National Board’s Guidelines for mandatory notifications7 and sections 130 and 141 of the National Law).
Chiropractors also have professional obligations to report to the National Board and their employer/s if they have had any limitations placed on their practice. Good practice involves:
7Available on the Chiropractic Board of Australia website.
Maintaining clear, appropriate, factual, objective and accurate health records is essential for the continuing good care of patients. Detailed guidance on this matter is available in the Guidelines for clinical record-keeping for chiropractors published by the National Board. Chiropractors should be aware of relevant state and territory legislation in relation to health records management. Good practice involves:
Chiropractors have a statutory requirement to ensure that they and their practice are appropriately covered by professional indemnity insurance (please refer to the National Board’s Professional indemnity insurance registration standard8).
8Available on the Chiropractic Board of Australia website.
Advertisements for services can be useful in providing information for patients. All advertisements must conform to relevant consumer protection legislation, and state and territory fair trading Acts and, if applicable, legislation regulating the advertising of therapeutic goods. In addition, the National Law is specific in its direction regarding the use of protected titles, including specialist titles. Good practice involves:
9Available on the Chiropractic Board of Australia website.
When a chiropractor is contracted by a third party to provide a legal, insurance or other assessment of a person who is not their patient, the usual therapeutic chiropractor-patient relationship does not exist. In this situation, good practice involves:
The community places a great deal of trust in chiropractors. Consequently, chiropractors have been given the authority to sign documents such as sickness or fitness for work certificates, on the assumption that they will only sign statements that they know, or reasonably believe, to be true. Good practice involves:
When providing curriculum vitae, good practice involves:
Also see Section 11.3 Assessing colleagues in relation to providing references for colleagues.
Chiropractors have responsibilities and rights relating to any legitimate investigation of their practice or that of a colleague. In meeting these responsibilities, it is advisable to seek legal advice or advice from a professional indemnity insurer. Professional conduct involves:
Patients rely on the independence and trustworthiness of chiropractors for any advice or treatment/care offered. A conflict of interest in practice arises when a chiropractor, entrusted with acting in the interests of a patient, also has financial, professional or personal interests or relationships with third parties that may affect their care of the patient.
Multiple interests are common. They require identification, careful consideration, appropriate disclosure and accountability. When these interests compromise, or might reasonably be perceived by an independent observer to compromise the chiropractor’s primary duty to the patient, chiropractors must recognise and resolve this conflict in the best interests of the patient. Good practice involves:
Chiropractors must be honest and transparent in financial arrangements with patients. Good practice involves:
As a chiropractor, it is important to maintain health and wellbeing. This includes seeking an appropriate work–life balance.
Chiropractors have a responsibility to assist their colleagues to maintain good health. Good practice involves:
10Available on the Chiropractic Board of Australia website.
Teaching, supervising and mentoring chiropractors and students is important for their development and for the care of patients. It is part of good practice to contribute to these activities and provide support, assessment, feedback and supervision for colleagues, chiropractors-in-training and students. It also adds value to the supervisor’s practice through engagement with the person being supervised and their learning needs. There are a range of supervision models being adopted in the health professions, including coaching, mentoring, observing and shadowing.
Assessing colleagues (including students) is an important part of making sure that the highest standards of practice are achieved. Good practice involves:
Students are learning how best to care for patients. Creating opportunities for learning improves their clinical practice and nurtures the future workforce. Good practice involves:
Research involving humans, their tissue samples or their health information is vital in improving the quality of healthcare, reducing uncertainty for patients now and in the future, and in improving the health of the population as a whole. Research in Australia is governed by guidelines issued in accordance with the National Health and Medical Research Council Act 1992 (Cth). Chiropractors undertaking research should familiarise themselves with, and follow, these guidelines. In addition, research involving animals is governed by legislation in states and territories, and by guidelines issued by the NHMRC.
Being involved in the design, organisation, conduct or reporting of health research involving humans brings particular responsibilities for chiropractors. Practitioners should refer to the NHMRC guidelines on this topic for detailed information.11 The key responsibilities, drawn from the NHMRC guidelines, include:
11National Health and Medical Research Council.
When chiropractors are involved in research that involves patients, good practice includes:
The Chiropractic Board of Australia acknowledges with appreciation the following publications that have been consulted in the preparation of this code:
Electronic means any digital form of communication, including email, Skype, internet, social media, etc.
Evidence-based healthcare is the integration of the best available evidence with professional expertise, in conjunction with patient preference, values and circumstances, to make healthcare decisions.
Patient includes client and health consumer.
Patient centred implies being respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient need and values guide the decision-making for that patient.
Practice means any role, whether remunerated or not, in which the individual uses their skills and knowledge as a chiropractor in their regulated health profession. For the purposes of this code, practice is not restricted to the provision of direct clinical care. It also includes using professional knowledge in a direct non-clinical relationship with patients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that have an impact on safe, effective delivery of health services in the chiropractic profession.
Providing care includes, but is not limited to, any treatment/care, advice, service or goods provided in respect of the physical or mental health of a person, whether remunerated or not.
Red flags are findings which may indicate a more extensive disease process that should attract a clinician’s attention as a matter of priority.
Social media describes the online and mobile tools that people use to share opinions, information, experiences, images, and video or audio clips and includes websites and applications used for social networking. Common sources of social media include, but are not limited to, social networking sites such as Facebook and LinkedIn, blogs (personal, professional and those published anonymously), WOMO, True Local and microblogs such as Twitter, content-sharing websites such as YouTube and
Instagram, and discussion forums and message boards.
Treatment, care, management and healthcare services are terms that can be used interchangeably for the purposes of this code.
The aim of this appendix is to assist chiropractors in performing health activities in a public setting in a safe and responsible manner. Chiropractors undertaking health activities in a public setting should also be aware of, and comply with, the provisions of the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law) that relate to advertising, the Code of conduct as a whole, with particular reference to Sections 6.4, 9.1 and 9.2, and the National Board’s Guidelines for advertising regulated health services (the Advertising guidelines), which can be found on the Codes and Guidelines page.
For the purposes of this appendix, health activities in a public setting means any activity that involves a chiropractor offering a service of either assessing the health of another party or providing health information (including spinal screenings) in a public setting for the purposes of promoting the health of the public. For the purpose of this code, a public setting for this activity would be deemed to be somewhere separate from the place where a practitioner might normally conduct paid clinical consultations.
Health activities in a public setting are fundamentally undertaken to disseminate information and understanding of health-related matters to the public and to carry out relevant health assessments in a public setting.
These activities must be undertaken in the public interest and seek to promote the health of the public and therefore must not be seen to have a direct promotional benefit to the practitioner(s) carrying out the activity. Examples of where a health activity in a public setting may be perceived as promotional may include but are not limited to; the use of practitioner-specific signage, use of letterheads, stamped brochures, business cards as part of the public health activity etc.
It is the responsibility of the individuals involved to ensure that, if required, all necessary permits are in place before starting a health activity in a public setting. No notification to the Chiropractic Board of Australia (the National Board) is necessary.
While the content and materials associated with a health activity in a public setting are not necessarily deemed as advertising for the purposes of the Advertising guidelines, it is expected that the material provided as part of such activities should in principle, be consistent with these guidelines.
Good practice in relation to health activities in a public setting involves:
For the purposes of this appendix promotional activities are defined as any activities undertaken by a practitioner in any setting that confer a direct promotional benefit to the practitioner(s) involved.
These activities must comply with the National Law, the Code of conduct, with particular reference to Sections 6.4, 9.1 and 9.2, and the Advertising guidelines, which can be found on the Chiropractic Board of Australia website.
Good practice in relation to promotional activities includes the good practice principles for health activities in a public setting (a) to (g) above and strict adherence to the Advertising guidelines. Practitioners must also ensure that the promotional activity is represented as a promotional activity.
Spinal screenings may be either a health activity or a promotional activity dependent upon the characteristics of each event.
Radiographic imaging is part of the suite of diagnostic procedures offered by chiropractors, either in a chiropractic office or through referral.
Chiropractors use radiography for several purposes following the identification of various history and examination findings, including: confirmation of diagnosis/pathology; determining appropriateness of care and; identifying contraindications or factors that would affect or modify the type of treatment/care proposed.
The aim of this guideline is to assist chiropractors in referring for, and undertaking, radiology and radiography procedures in a safe and responsible manner.
Chiropractors must comply with the provisions of the code of practice for radiation protection and the Application of ionizing radiation by chiropractors (2009) or any subsequent version as published by the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA Code), and applicable Commonwealth, state or territory laws in relation to best practice (see www.arpansa.gov.au under Publications).
The Chiropractic Board of Australia (the National Board) recommends that practitioners note the following points from the ARPANSA Code:
1. The key purposes of the ARPANSA Code are to:
2. The key radiation protection principles of the ARPANSA Code are:
Justification - No practice involving exposure to radiation should be adopted unless it produces sufficient benefit to the exposed individuals or to society to offset the radiation detriment it causes – the procedure must be justified for that individual patient.
Optimisation - Radiation doses must be kept ‘as low as reasonably achievable’ (ALARA).
Dose limits - Applications of ionising radiation must be managed in a way so as not to exceed dose limits specified in RPS1.
In addition to the ARPANSA Code, the National Board reaffirms and clarifies the following points:
The ultimate judgement regarding the application of any radiation-based procedure must be made by the chiropractor in light of all the circumstances presented and in an evidence-based context.
The aim of this guideline is to assist chiropractors in their clinical decision-making. This section should be read in close conjunction with Sections 2.1 and 2.2.
The Chiropractic Board of Australia (the National Board) supports and recommends that practitioners are familiar with the following key points:
1. A program of care should be developed in a patient-centred and evidence-based context and:
2. Review/reassessment should be periodic, and should include:
3. A patient may elect some form of ongoing or supporting treatment/care as a part of their overall health management. This form of care has the same requirements in relation to informed consent and explanation of anticipated outcomes as any other care.
4. Should any patient elect to undergo regular chiropractic examination or treatment/care in the absence of symptoms, it is the responsibility of the practitioner to provide the patient (parent/guardian for children) with a balanced, evidence-based view of the clinical justification for such procedures.