same can be said for populations that represent diverse gender identities and sexual orientations. These groups represent underserved populations that can extend and grow massage and body work practice that is good for business and promotes acceptance of these populations in the community (Haines, 2016). Sex and gender on forms When making decisions about when and how to inquire about gender or sex on your intake forms, the following information outlines appropriate reasons: ● Massage and bodywork practice is often part of an interdisciplinary medical practice that requires this information. ● As part of a nonprofit organization, this information may be required to track clients to maintain gender-specific grant funding (Haines, 2016). Any concerns about medical conditions should be covered on the medical history form. It is an incorrect to assume that specific populations will have certain medical conditions simply based on gender or sex. Bathrooms Recent federal and state legislation concerning the assignment of gender to bathrooms has made this issue highly controversial in recent months. It is an issue that must be addresses and the practitioner can decide to declare bathrooms as gender free, allow clients to use whatever gender designated bathroom they choose, allow both types, and provide a family bathroom for fathers or mothers with children. This issue will be more complicated if the practice does not own or have control of the space and therefore unable to alter bathrooms. In these cases the practitioner is challenged to find a way to provide a creative and equitable solution to the problem. Ongoing education and awareness As in all areas of practice, new legislation, scientific and medical advances, cultural and societal changes, and new terminology and language, must be accommodated to maintain an effective practice that keeps pace with population needs and demands. In order to remain current and provide the best practice for client care, it is important for the practitioner to continue their education and training in all areas relevant to the profession. This includes making necessary changes and adaptations to the practice and educating all staff to be sure they share a commitment to ethical and equitable practice that includes all clients. Beyond the professional obligation to treat all clients in accordance with the standards and ethics of the profession, it is up to the practitioner to decide the level of support or advocacy they chose to provide to populations representing diverse gender identities or sexual orientation. Decisions concerning marketing materials, community presence, and support of diverse communities will vary depending upon the philosophy adopted by the practitioner and the way they want to portray Ethical considerations of hospice massage Massage and bodywork professionals follow ethical standards and guidelines within their scope of practice. If that includes working with clients in hospice care the practitioner must be prepared to face ethical issues that may lead to dilemmas related to hospice end-of-life care. As massage therapy is increasingly integrated into all phases of modern day health care from infancy to gerontology, the practitioner may be called upon to work with clients in hospice or other forms of end of life care. Advances in medical treatment, technology, and changes in attitudes, and legislation about care for the terminally ill presents ethical dilemmas and conflict for the family and all care givers. Dr. Richard Fife, an ethicist, states: “In hospice care, staff members are constantly faced with the possibilities and realities of ethical dilemmas” (Fife, 2005). He reports findings from a two-
their practice to the public. There are no right or wrong answers or blueprints to guide the professional through to these issues as long as the practice is founded on the ethics of the profession. Gael Wood (2016) proposes ten things that the massage and bodywork professional can do to welcome LGBTQ individuals to their practice. She notes that many members of this community worry that they will not feel comfortable and are hesitant to seek services. Wood provides the following information to welcome LGBTQ clients: ● Look over intake form, as they may contain outdated or unnecessary questions about gender, marital status or the relationship to an emergency contact. A quick fix is to have a blank to fill out rather than a box to check. Also determine if any of the health questions could be reworded or are unnecessary. ● Use gender-neutral bathroom signs, if there is a single bathroom. A bathroom is a bathroom, after all. A great bonus of this is less waiting for the right one to be empty. ● Be aware when asking personal questions. A simple “Do you have children?” can be hard on some clients, for various reasons. Stick to asking clients about their needs and activities that will inform ability to provide an effective massage or bodywork session. ● Reach out in person at local events like pride days or LGBT Center events. Just search Google for LGBTQ events in the city. Practitioners may volunteer, give a talk about stress, and how massage can help relieve it, or offer chair massage. ● Get the word out on social media. Use rainbows, because the rainbow flag is commonly used as a symbol of LGBTQ pride and LGBTQ social movements, and let the community know the practice welcomes LGBTQ clients. ● Stay educated about LGBTQ terminology and concerns. Be flexible and willing to change as health care professionals that must stay informed and meet client needs. ● Of course, client confidentiality is a top priority for all clients, and professionals must make sure that all clients understand that their information will never be shared or discussed. This can eliminate any concern about clients might have about their privacy. ● Add a phrase such as, “All Are Welcome Here,” or “Welcoming Practice,” to your marketing materials. This way, people will know the practice is supportive of diversity and will be more comfortable visiting the practice. ● Invite back each client that receives care or contacts the practice for information and be sure to address the mental and physical benefits of the practice. ● Keep an open mind and conduct self-assessment to evaluate beliefs and values. By examining those values and keeping an open mind practitioners grow and change. As the great Maya Angelo said, “I did then what I knew how to do. Now that I know better, I do better.” year study of ethical dilemmas faced by hospice staff. Some of the most common issues included Fife notes are as follows: ● Working with clients who have been admitted without a do- not-resuscitate (DNR) order. ● Withdrawal or withholding of nutrition/hydration. ● Patient autonomy versus patient safety and physical needs. ● Conflicts with the patient’s family or significant others. ● Conflict over whether to follow a patient’s wish to be discharged from a hospice unit when the staff member feels that the primary caregiver is incompetent to take care of the patient. ● Pain medication and respiratory distress/consciousness. The question here being whether the pain is so great that it is necessary to adversely affect consciousness and cause some respiratory distress by the higher use of medications
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Book Code: MTX1323
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