In all chiropractic colleges, a course is offered in Ethics and Jurisprudence, which inculcates in novice DCs the principles of right behavior and the legal concepts which the chiropractor is likely to encounter. The ethics part of the course is used to discuss our obligations as humans and as professionals, to assure that our behavior falls within the guidelines generally considered acceptable by society.

As humans, we behave according to a personal ethical or moral code whether or not it is formalized by a religious organization. There are some general expectations of members of society which we try to teach our children, and to which we largely try to adhere. Some of these principles  of personal ethics are:

• caring about the well-being of others

• respecting others' rights of self-direction

• being trustworthy and honest

• complying with the laws of society

• being fair in our dealings with others

• doing good / preventing harm

As professionals, we accept an additional layer of ethical obligation which assures that we will act properly in relationships with clients or patients. We have institutionalized professional ethics by creating codes of ethics, rules of professional conduct and disciplinary boards to enforce them. Some of the elements of professional ethics are:

• maintaining objectivity and impartiality

• disclosing any hidden interests

• upholding strict confidentiality

• being duly diligent

• exercising professional responsibilities faithfully

• avoiding conflicts of interest

Insurance companies and managed care organizations are composed of humans with the same personal ethical obligations as chiropractors. Because of the structure of their organizations, they owe allegiance to their shareholders to run the companies in a way which will insure a profit. The shareholders are also humans with a personal ethical and moral obligation to abide by the guidelines above. Why then, is there conflict between insurance companies and the chiropractic profession concerning the application of chiropractic care to our patients?

Some observers of health care providers and patients in conflict with insurers believe that the insurers have stepped over the line into the territory of unethical behavior. It is sometimes stated that insurers have become so infatuated with profits, that they have all but abandoned the "Good Neighbor" and "Good Hands" posture promoted in their marketing campaigns. The good neighbor who abandons you when you are in trouble, or the good hands that drop you like a rock when you are in need seem to be the reality today. Insurers, in pursuit of profits, seem to resort to some interpretive chicanery in the words of their agreements with their insured parties. Terms like "reasonable and customary" and "medical necessity" seem to always be translated in favor of the insurer.

Next page of article