Informed Consent, Patient Rights, and Mandatory Reporting
Informed consent
Consent is a process, not a signature. Before treatment the licensee should explain the condition, the proposed adjustment and what it involves, the material risks including the recognized serious vascular risk associated with cervical manipulation, reasonable alternatives including medical care and watchful waiting, and the likely course and cost. The patient must be free to decline or stop. Consent obtained by a technician or receptionist is not the licensee's consent, and both the discussion and the patient's agreement belong in the chart.
Patient rights
Minnesota's patient bill of rights, Minn. Stat. section 144.651, sets out rights to respectful care, privacy, information, and refusal; chiropractic practices should treat these as operating standards regardless of how the facility definitions are read. Minors require parent or guardian consent; the age of majority is 18, and the limited minor-consent statutes do not generally reach chiropractic care.
Mandatory reporting
Two statutes drive most exam questions here. Minn. Stat. section 626.556 requires a report when a licensee knows or has reason to believe a child is being maltreated; Minn. Stat. section 626.557 does the same for vulnerable adults. In both, report immediately by telephone to the common entry point, follow with the written report the statute requires, do not investigate, and document that you reported. Good-faith reports carry immunity, and failure to report is a criminal offense. Separately, Minn. Stat. section 214.17 requires reporting an impaired or unethical licensee to the Board.
Worked example
An 82-year-old arrives with a caregiver who answers every question and mentions a recent fall. Bruising on the upper arms suggests restraint. Reasonable suspicion is enough: the licensee calls the common entry point the same day, files the written report, and records the concern and report number.
Traps
Waiting for proof; letting the caregiver's explanation close the issue; delegating the call to staff and assuming it happened; assuming HIPAA blocks reporting, when it expressly permits reports to abuse and public health authorities.