Standards of Ethical and Professional Conduct
Domain 2 tests the fiduciary and professional duties that accompany a Pennsylvania chiropractic license. Questions typically involve informed consent, confidentiality, boundaries, recordkeeping, advertising, billing honesty, impairment, and mandatory reporting.
Consent and confidentiality
Informed consent is a process, not a signature: explain the diagnosis, proposed care, material risks, alternatives including no treatment, and document the discussion and any refusal. Confidentiality is the default; disclose only with a valid authorization, as required by law, or under valid legal process. A subpoena alone is not authorization-the patient must consent or a court must order disclosure. Share the minimum necessary.
Boundaries, records, and honesty
Sexual contact or a romantic relationship with a current patient is prohibited and is unprofessional conduct. Use chaperones for sensitive examinations and avoid dual relationships that impair judgment. Records must be contemporaneous, legible, and sufficient to justify the diagnosis, care, and charges; later alteration is fraud. Advertising must be truthful and not deceptive; avoid guarantees of cure.
Mandatory reporting and impairment
Chiropractors are mandated reporters of suspected child abuse under Pennsylvania’s Child Protective Services Law and must report to ChildLine immediately; they do not investigate. Practicing while impaired is a violation; self-reporting and complying with treatment monitoring can mitigate but not erase the violation.
Worked example
A patient mentions that her boyfriend’s child has a belt-mark bruise. The chiropractor must report the suspected abuse; patient confidentiality does not block a mandated report, and the chiropractor should not question the child or contact the family first.
Traps
Treating a signed form as consent without discussion; disclosing records on a subpoena alone; assuming “the patient consented” excuses sexual contact; and charting late or defensively, which undermines credibility.