● What hobbies or recreational activities do I do? How often do I do things just for me? ● Am I sleeping enough? ● How are my eating habits? Internet and social media Ethical violations in the areas of confidentiality and boundary issues often occur because of inadvertent mistakes using electronic media for information storage or transmission. Websites can be an effective marketing tool to reach potential clients and they can access information on the anywhere and at any time. Social networking sites are effective in connecting with others, providing updates and advertising business topics. It is important to consider personal and professional boundaries when developing a profile that should be professional and representative of the ethical standards of your practice. The social media profile is the first impression clients will have of the practice and it may have a profound impact and set the tone of future relationships with clients. If boundaries are not maintained, the practitioner may disclose aspects of their personal life that cannot be reversed. The practitioner must also decide how to handle requests from clients to be “friends” on social media, which may open the door to boundary crossings if they do not keep their personal and business networking separate. Using advanced privacy settings on personal profiles is advised. Any representation, text or visual, must be carefully considered because it not only reflects on the practitioner but the profession as a whole. Never post any comments or photos of clients on any pages that can be viewed by others which would be a violation of confidentiality ethics standards. This would include scheduling or confirming appointments, which should only be done through private messages on a secure site. When using email to communicate with client, always follow business email etiquette, be sure the text is free of grammar and spelling errors, and reflects a professional, conservative image. Never send out group emails that will disclose the addresses of all clients to each other, as this is a breach of Investigating and ethical dilemmas The term ethics includes the study of moral decision-making (Dail, 2012). Ethical dilemmas are situations that violate the code of ethics and conduct standards of a profession. Ethical dilemmas also involve practitioner and client values, beliefs, experiences, emotions and level of trust and communication skills. The professional massage and body work professional must be cognizant of areas of practice that may lead to ethical dilemmas as well as concepts of power, professional responsibilities, effective communication, trust building, client autonomy and role in their care as a foundation to maintaining ethical practice. The competent and experienced practitioner will also be able to identify warning signs that issues are developing and address them with clients before they evolve into the level of an ethical dilemma. In a practice that is committed to ethical standards and conduct, dilemmas will often occur in subtly rather than resulting from gross negligence or malpractice such as inappropriate sexual conduct with clients. From the beginning, the practitioner must take the time to clearly establish their professional role and boundaries and
● Do I exercise enough? ● Do I have any medical conditions that I need to address? Do they impact my work?
confidentiality and HIPAA rules. It may be advisable to use an email provider to send out newsletters or information to the entire client base. Maintain a separate cell phone number for the business if possible that contains a professional greeting and message. Do not answer the phone in a public place that will allow others to hear the conversation or any identifying information that would constitute a confidentiality and HIPAA rule violation. It is also important to promote a professional image by conducting phone conversations in a quiet, private area, free of noise and distractions so that both parties can easily hear and communicate effectively. When writing a blog to share information, be sure to keep the content professional, error free, and devoid of any identifying client information to insure privacy and confidentiality. Blogs should also be free of advertising that will distract from the topic and may include content that is counter to the practitioner’s professional image. Finally, when sending faxes that contain client information, always use a cover letter, be sure the fax number is correct and that it will be received by the appropriate staff to maintain confidentiality. Any massage or bodywork professional website, networking site or social media page should review their code of ethics, any state law and HIPAA rule that regulates technology within and outside the state boundaries of the professional license or certification. In recent years, many systems have been compromised, hacked or cracked resulting in lost or stolen personal, medical and financial information. The practitioner can never be completely confident that they can protect the privacy rights of clients when using technology for communication. Practitioners must follow numerous safeguards and be extremely vigilant when using technology in their practice. maintain this level of standards-based conduct with each client interaction. They must be firm in communicating that they will not provide services that are illegal or unethical despite the requests of the client. This includes not using massage or bodywork modalities that are experimental, outside the scope of practice or the practitioner’s competence. Additionally, the practitioner must clarify the role of the client in truthfully disclosing medical information, communicating preferences, actively participating in their care decisions, maintaining boundaries and appropriate client conduct, following practice rules. Establishing and documenting these understandings in a therapist/ client agreement will set the foundation for effective and ethical practice and help to prevent misunderstandings or expectations that lead to ethical dilemmas in the future. As previously discussed, ethical dilemmas may occur even in the best of practices, despite the groundwork and agreements to prevent them. Ethical dilemmas can range from minor and easily solved dilemmas, to major dilemmas, resulting in ethical violations, lawsuits, and license or certificate revocation. Since these may occur in the private treatment room, the practitioner and client are the only
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