Medical Ethics

ALLIANCE OF REGISTERED HOMEOPATHS

http://www.a-r-h.org

CODE OF ETHICS AND PRACTICE

1. Introduction
Patients rely upon, and have a right to be able to place trust in, their healthcare
practitioners, who must therefore maintain high standards of care, competence and
conduct. Fellow healthcare practitioners also deserve respect and have a right to be
treated properly.

This Code of Ethics and Practice summarises the standards set by the Alliance of
Registered Homeopaths (ARH). All its registered members (referred to as members in
this document) agree to abide by the Code, which offers guidance on the observance of
the standards, indicates areas where particular challenges may arise, and forms the basis
for assessing the professional conduct of any member against whom a complaint has
been made – though it in no way restricts anyone’s legal rights in the event of a
complaint.

Such a code cannot be all inclusive, but it does set out the principles of ethical
professional conduct as a guide to all concerned.

Members should be aware that standards of good practice have been agreed throughout
the profession in the form of the National Occupational Standards for Homeopathy.
Ideally, members should be acquainted with the recommendations set out in these
Standards, copies of which are available from the Improvement and Development Agency
(tel. 020 7296 6600).

In healthcare, many decisions fall into areas where there is no absolute right or wrong
and where a series of conflicting obligations may have to be considered. The principles
laid out in this Code and in the National Occupational Standards for Homeopathy are
designed to enable members to act in a professional manner when faced with such
situations.

A member’s ability to follow these principles both in spirit and letter demonstrates their
competence and fitness to practice, and ensures their continued registration with the
ARH.

2. Basic Principles
The following are the basic principles all members should reflect on and adhere to:

2.1 Clarity of Contract

In order to ensure patients are able to make informed choices with regard to their
healthcare, members should give full and clear information about:

• duration and frequency of appointments

• charges

• availability for advice

• locum coverage

• emergency contact

• confidentiality and its breaching through disclosure

• security of records

• the place supervision plays in their practice.

Ideally, this information should be given in writing, before entering into the therapeutic
relationship. Often the best way to do this is to include it in a clinic leaflet, thus
establishing a clear contract with patients.

Practices other than homeopathy

If, during the course of treatment, it is considered appropriate to employ therapies other
than homeopathy, the member will practise these therapies with integrity and
competence. The nature of the treatment offered should be made clear to the patient.
members should indicate their relevant qualifications, membership of a registering body
and adherence to a separate Code of Conduct for the practice of such additional
therapies. It is necessary for the member to hold professional conduct insurance
applicable to every aspect of the patient’s treatment.

Referrals

Patients may refer themselves directly for homeopathic treatment. They should be
encouraged to inform their GP or healthcare practitioner that they are receiving
homeopathic treatment and, with the patient’s consent, the member may also inform
the GP of this in writing.

A GP who formally delegates the care of a patient within the NHS retains overall clinical
responsibility for that patient.

Details of all recommended referrals to other homeopaths or healthcare practitioners
are to be recorded in the patient’s notes at the time the recommendation is made.

In all these matters, if at any point the patient declines to give consent for the member
to make this contact, their wishes must be respected at all times and recorded in their
notes.
Hospital treatment

Where a patient or a patient’s representative requests homeopathic treatment to be
initiated or continued within a clinical setting (e.g. a hospital or hospice), both nursing
staff and the person with overall clinical responsibility are to be notified of this request
by the patient or their representative.

2.2 Informed Consent

In order to ensure the patient is able to give informed consent with regard to their
healthcare, the member should give full and clear information about the nature of
homeopathic treatment, both before that treatment begins, and as appropriate during
that treatment.

2.3 Accuracy of Records

All case notes will be clear, legible, and contain all the relevant information relating to
the progress of the case. They will enable a third party to have an understanding of the
patient’s state at the time of a consultation, and of whether the patient has improved,
maintained or deteriorated in their condition since they were last seen. This is
particularly important should the member at any time be involved in legal proceedings.

To ensure continuity of care, the treatment of a patient known to be under the care of
another homeopath should ideally not be undertaken without informing them and
requesting details of the patient’s treatment to date. However, this must be done with
the patient’s full knowledge and consent. If the patient does not agree to this, a note of
this fact should be recorded, indicating that continuity of care could not be achieved.

Where a patient requests the record of their treatment, or asks that it be forwarded to
another homeopath or other practitioner, it is important to send a copy of all
information from that patient’s case notes as quickly as possible. The full original notes
are to be retained by the member. A reasonable charge to the patient for this service
might be considered.

Patients should be notified in the event of the death or incapacitating illness of the
member treating them. The member will make prior arrangements for case notes to be
returned to patients, or destroyed.

2.4 Competence & Continuing Professional Development

Members should be aware of the extent and limits of their clinical skills, monitoring
them as necessary, using the tools of reflection and audit.members should be able to
refer patients appropriately to other practitioners when necessary. Members should
actively extend their knowledge base through continuing professional development
(CPD). CPD may include supervision, conferring with colleagues either personally or via
email, and acquiring knowledge of new theory and practice through further training and
study (e.g. attending appropriate seminars and post-graduate training courses or
contributing to an on-line homeopathic mailing list). CPD may also involve complying
with any statutory or ARH requirement that may be in force.

Failure to engage periodically in a reasonable amount of post-graduate education may be
taken into account when hearing allegations which call a member’s professional
competence into question.

2.5 Confidentiality & Disclosure

Members must ensure that patient information is kept secure and confidential, access
being restricted to the member and their assistants or agents, unless the patient agrees
otherwise in writing, or unless access is requested through due process of law.

Storage

Full and clear records of all treatments of patients should be made, kept, and stored for
at least seven years from the date of the last consultation, ensuring compliance with the
requirements of the Data Protection Act, whereupon they can be destroyed, with care
taken to preserve complete confidentiality.

Disclosure without consent

Disclosure without consent is a difficult issue, particularly if the member has promised
total confidentiality to the patient. For the most part, the question of confidentiality is
subject to the contract between each individual patient and their practitioner, but there
are instances where there is a conflict of interests between a member’s duty to society
and their duty to their patient. As members are subject to the law of the land in which
they practise, they must disclose records if ordered to do so by a Court. A member can
of course make every reasonable effort to persuade the patient to change their attitude
and to disclose information themselves.

It is important for members to clarify their policy on confidentiality before treatment
commences. It is recommended that this be clearly set out in the clinic leaflet. In the
event of a later dispute, this will constitute a written record of what has been
contracted between the patient and practitioner.

2.6 Clarity of Service

Members must establish and monitor clear boundaries between all parties to the
therapeutic relationship in order to maintain the impartial professional position that
needs to exist.
Thus, whilst it is not the object of these ethical guidelines to go into the realms of
morality, some points must be made.

On most occasions any form of emotional, intimate or sexual encounters between a
member and their patient, student or supervisor can be construed as an abuse of trust
and power. Such situations are therefore to be actively discouraged, particularly if the
relationship is clandestine.members should actively avoid placing themselves in such a
situation. Any complaint against a member resulting from such actions will be dealt with
severely by the ARH if there is evidence that there has been an abuse of power or trust.

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