Chiropractic Patients Need To Know Treatment RisksPublished: 2009-05-06 14:11:30Author: Rick Green | Hartford Courant | March 17, 2009If you have received a flu shot, you signed a piece of paper that included, buried in the fine print, a warning like this:
In approximately 5 percent of the cases a permanent or even fatal form of paralysis may occur.
This is known as "informed consent," and the idea is to make the
patient aware of the risks. Most of us ignore this and get on with the
injection.
Again this session, this seemingly simple, ethical concept has
legislators tied in knots over whether it should be extended to a
specific spinal adjustment procedure performed by chiropractors.
"It's dangerous when you try to make law on individual isolated situations," said state Sen.
Jonathan Harris,
chairman of the legislature's public health committee. "We are working
on getting both sides of this issue together to come up with a
meaningful solution that offers protection to the public that doesn't
single out a profession."
I'm for that. But I'd also like to know there's a chance — however
unlikely — that neck manipulation by a chiropractor could cause a
stroke.
State chiropractors are fighting the proposed informed-consent law. The
chiropractors say they are all for doing this, but they want it to
apply to anyone who performs a procedure involving the neck, such as
hairdressers. This is an obvious smoke screen.
Still, the chiropractors have a point: The chance for a disaster is
very remote. I'm not sure, though, why this means they shouldn't be
required to inform patients of the potential risk from the procedures
they perform, including "a discharge summary" of all potential side
effects.
"The research shows that this type of treatment is the safest for neck pain or headache," said Dr. Matthew N. Pagano, a
Winsted chiropractor. Mandating informed consent creates "an inference that this type of treatment is dangerous."
"The risks associated with this procedure are so low that if the
legislature is going to contemplate mandating written informed consent
it should be done for all professions with respect to all medical
procedures that have a higher risk."
The chiropractors say they believe in the concept of informed consent.
Many do it voluntarily. But the state has no business singling them
out, they argue.
"It's tough for me to reconcile as well," said state Sen. Len
Fasano, sponsor of legislation that would require chiropractors to tell
patients about all the risks. "The first story you get is we do
informed consent, anyway. The second story we get is why are you
picking on us?"
Fasano has modified his proposal to say that any physician who performs
neck manipulation must practice informed consent. The chiropractors say
this still singles them out.
"The chiropractors are all over this. It's a lot of pressure," Fasano
said. "Legislators are getting called left and right. They are very
vocal. They are saying things that are not quite accurate, like we are
singling out chiropractors and there is no such thing as a stroke"
caused by cervical manipulation.
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