CHIROPRACTIC APOLOGETICS PART IV Legal basis for straight chiropractic
The legal basis for straight chiropractic is probably one of the most controversial and yet one of the simplest areas to explain and understand. One of the beautiful things about the practice of straight chiropractic is that the best interests of the chiropractor and the best interests of the patient are never in conflict. This cannot be said for other branches of the "healing arts." Often the medical doctor, for example, will recommend costly and invasive tests which are not necessary for the patients' benefit and are only designed to protect the doctor legally. Within the practice of straight chiropractic there is nothing the chiropractor must do that is not completely in the best interest of the patient. This is important because in explaining the straight chiropractic rationale to legislators, who, after all, determine the legal basis for the practice of all chiropractors, straight chiropractic is put in a much more positive light than other types of practice. As a side note, this is the reasons that the "live and let live" philosophy can never work. If chiropractic could practice outside the framework of a legal system, then we could all practice as we like. But what one doctor of chiropractic does affects every other chiropractor in his area, and even statewide. No one practices in a vacuum. If laws are passed stating that a chiropractor must make a medical diagnosis then there is no longer the practice of straight chiropractic. Any mixer surely should see the fear among the straights that the day will come when these laws are passed. Conversely, there are many mixers who sincerely believe that if a straight does not form a diagnosis before beginning care, he is practicing a dangerous form of chiropractic. Clearly, we need two professions. Getting back to straight chiropractic's legal basis, it is not difficult to demonstrate to a legislator, or anyone else, that practicing straight chiropractic is legally the safest type of practice, and presents the least possible harm to the patient. All studies in the area of malpractice show that misdiagnosis, failure to diagnose, and failure to refer out are the leading causes of malpractice claims. This is why straight chiropractic is so safe. You cannot misdiagnose if you do not diagnose. You cannot fail to diagnose if diagnosis is not part of your procedure. The difficulty lies in explaining to people that we are practicing a health care profession which does not necessitate diagnosing or treating diseases. Strangely enough, the easiest people to explain it to are members of the medical community. Perhaps they are anxious to believe that chiropractors are not in competition with them for the treatment of diseases. The most difficult, even impossible, group of people to explain it to is the mixers. Next in line is the public, because most of their contact with the health care community has been with the disease treatment model, and most of the chiropractors out there are practicing a drugless disease treatment model. Clearly, the weakest aspect of the practice of straight chiropractic is its ability to explain the straight chiropractic concept of health and "non-disease treatment" care. But it is a problem of practice and communication, not of straight chiropractic itself. If this concept is explained properly, and it should be for the sake of the patient and the protection of the chiropractor, straight chiropractic is the safest, most easily defensible way to practice chiropractic.
ASSUMING RESPONSIBILITY FOR ONE'S DECISIONS
Our chiropractic philosophy has answers to many of the questions that plague society. One of these questions is that of responsibility. The philosophy teaches that there are no accidents in nature, everything happens for a reason, and behind it is a cause. When it comes to illness, society seems to lose sight of the cause-effect principle. Disease is seen to be a matter of bad luck or being in the wrong place at the wrong time. Yet there is as much a cause of any disease as anything else and invariably the cause can be traced back to decisions made by the patient. B.J. once said that "when man violates man's laws we send him to jail and point the finger of scorn at him. When he violates nature's laws we send him to the hospital and give him flowers. Odd isn't it?" Sickness comes about by violation of one or more of the laws of nature. It may be diet, hygiene, rest, exercise, or the law dealing with the maintenance of the integrity of the nervous system, which is what we in chiropractic call the Law of Life. (Life is the expression of intelligence through matter.) Disease always comes about by a violation of a law. One sociological game that is played today that does not hold up under the scrutiny of our chiropractic philosophy, is to absolve people of responsibility for bad decisions, especially if they were ignorant at the time that they made them. Yet that thinking is contrary to reason. If I fail to see a six foot hole in my path, I am not exonerated from the penalty of violating (or attempting to violate) the law of gravity. Ignorance does not even slightly soften the blow. As my father used to always say "you should have been looking where you were going." Sickness occurs from violation of the laws of nature. Because a person is ignorant of those laws does not negate the responsibility. People must know that they have violated Nature's laws and that is why they are sick. This places the responsibility of learning about health upon the person. If people do not learn, it is their fault, their responsibility, and they will suffer the consequences. As unpleasant as it might be to tell people that, we as chiropractors must. To allow them to go their merry way, thinking that ignorance of the laws of nature is bliss, is unfair. Even chiropractors sometimes lose sight of the patient's responsibility. That fact was evident in an advertisement that came through the mail recently. The ad was for some sort of obesity management system. The opening line of the accompanying letter said "The time has come for us to take responsibility for our patients who are fat." That is probably one of the most ridiculous statements I ever read. Fortunately, it was written by a medical doctor and not a chiropractor, but it underscores the prevalent thinking. Heavens, the patients cannot be responsible for their obesity! As if I shoved Twinkies down their throat, or forced them not to exercise. Obesity has a cause, thousands of decisions an individual makes during his or her lifetime. Until people realize it is their decisions that got them to that point and their decisions that must make a change, they will never improve. That goes for obesity, sickness, and just about every other problem. This thinking which we call the "Above-Down-Inside-Out" viewpoint changes our ideas about hundreds of social issues. It doesn't really matter if alcoholism is a disease or not, as many argue. Even if we classify it as a disease, the patient is just as responsible for having it. If someone catches a cold he is responsible. Even if he says "I did not know the person I caught it from had one," he still chose to come in contact with that person, and ignorance is no excuse. But what is more important, he chose, willfully, to allow his resistance to get low. He chose to not get enough rest, to not eat a proper diet, to stress his body and to not get adjustments to maintain the integrity of the nervous system. He caught the cold! Or we might say he allowed himself to be caught by it! There is a practical application, because chiropractic philosophy is practical. We must teach our patients that their health is their responsibility, not ours. We may have to be stern with them. They have been taught incorrectly by medicine all these years that their health is the doctor's responsibility. But they are still responsible if they believed him. Anybody who would let an M.D. have responsibility for their health is foolish. Is the M.D. going to get sick for them if his care is inadequate? Will he be willing to have the side effects of the drugs he prescribed for them? Is he ready to drop dead in their place because of a heart problem he never diagnosed? Obviously giving someone the responsibility for your health when you must suffer the consequences is foolish. We must explain this to the patient in no uncertain terms. Every person must make hundreds of decisions every day concerning their health. If they make the wrong ones, whether out of cognizance or ignorance doesn't make a bit of difference in the end. They must know what is right concerning every aspect of their health and then choose to make the right decisions. As chiropractors, we must teach this concept to them. That, and correcting their vertebral subluxations, is where our responsibility as chiropractors begins and ends.
