Professional Practice, Ethics, and Safety
Core concepts
Know informed consent, scope of practice, confidentiality, documentation standards, and the duty to refer. Consent for OMT includes explaining the technique, alternatives, expected effects, and rare risks - particularly for cervical thrust techniques. Safety includes screening for contraindications, draping and chaperone practices, and recognizing adverse events.
Ethical reasoning
Apply the standard principles: autonomy, beneficence, nonmaleficence, and justice. Questions often present a conflict - a patient requests a technique that is contraindicated, or declines recommended referral. Respect autonomy while clearly documenting the discussion and your recommendation, and do not abandon the patient.
Traps
- Assuming a signed general consent covers every specific technique.
- Continuing treatment when findings worsen rather than reassessing and referring.
- Breaching confidentiality in casual conversation or in shared spaces.
- Practicing beyond training or licensure scope.
- Failing to document advice given when a patient declines it.
Rule of thumb
If a reasonable colleague would want it documented, document it - especially refusals, warnings, and referrals.
Worked example
A patient with known cervical instability requests a thrust technique. Explain why it is contraindicated, offer alternatives, document the discussion and the patient's response, and arrange follow-up - that satisfies both nonmaleficence and autonomy.