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.
3. Legal Obligations
Members have a duty to be aware of those ways in which the law
of the country in which
they practise affects their practice. If these obligations are overlooked,
members may
become involved in difficulties with state authorities, or with
other professional or
institutional organisations.
Members are required:
• To comply with the law of the state, territory or country
in which they practise.
• If a member of another professional register, to be aware
of any statutory or
voluntary requirement imposed by its Code of Ethics.
• To inform patients about the nature of homeopathic treatment,
before that
treatment begins.
• To tell patients the identity of the remedy prescribed,
if asked.
• To provide clear instructions for each prescription made.
For telephone
consultations, a written record of instructions given should be
added to the
notes.
• Not to use the title ‘Doctor’ in connection
with homeopathic practice, unless the
member holds a recognised medical qualification and is registered
with the
appropriate state medical register. Whilst it is appreciated that
members with a
PhD in other areas have the right to use the title ‘Doctor’,
the ARH expressly
forbids its use when it might be misleading to the patient. There
are Doctorates
in Homeopathy available in countries outside the UK, but the ARH
can have no
way of checking the validity of the training involved in gaining
such a
qualification. Therefore, unless an exception is granted to this
rule by the Board
of Directors, no member other than a medical doctor registered
in the UK may
use the title ‘Doctor’.
• Not to refer to assistants as 'Nurse', unless they are
currently registered as such
with the United Kingdom Central Council for Nursing, Midwifery
and Health Visiting, or the equivalent state medical register
of the country in which they
practise.
• Not to conduct any intimate physical examination of a
patient without the
presence of a third party acceptable to the patient, unless the
patient gives
prior written consent.
• To conduct a physical examination of a child under 16
only in the presence of a
parent or legal guardian and with that child’s clear consent.
• To register under the Data Protection Act where this
is required.If in doubt, the
member should call the information line of the Data Protection
Commissioner on
01625 545745.
• To provide patients, on request, with access to their
case notes. Statutory right
of access to any written health records exists under a number
of pieces of
legislation including: Professions Supplementary to Medicine Act,
Human Rights
Act,Data Protection Act.
• Not to draw up or sign any false or misleading documents,
reports or
certificates.
• To obtain patients’ active consent to sensitive
personal data being recorded in
their case notes.
• Not to record the patient on film or through digital
imagery or sound recording
without their prior written consent.
• Not to claim or imply, orally or in writing, to be able
to cure any named disease.
• To be aware of those diseases which are notifiable,and
to refer patients
immediately to their GP if such a disease is suspected.
• Not to treat animals and charge a fee. Only a vet may
do this. However, it is
perfectly proper for a vet to ask a member to treat an animal
under their care.
Premises
Members are also required:
• To comply with Local Council Regulations and the advice
of their local
Environmental Health Officer regarding adequate facilities such
as heating,
lighting, ventilation, toilets, electrical installations, smoke
alarms and fire
extinguishers.
• To protect the safety of the public and those people
working on the premises by
establishing suitable working conditions.
• To make a first aid kit available at all times (Shops
and Offices Act).
• To regularly review facilities and working practices
in order to ensure they
comply with current standards. Members should be aware of their
responsibilities under Health and Safety legislation (Health &
Safety Act)
whether as employer, employee or self-employed practitioner.
• To hold suitable third party liability insurance covering
their premises.
4. Advertising & Media
All advertising must be decent, legal, honest and truthful, and
must conform to relevant
guidance such as the British Code of Advertising Practice.
Professional advertising may indicate special interests, but must
not make claims of
superiority or disparage professional colleagues or other professionals.
It must not be designed to mislead or deceive, or make unrealistic
or extravagant claims.
5. Where Things Go Wrong
5.1 Problems with health
The interests of patients must come first at all times, and must
not be compromised. If,
therefore, a member’s mental, emotional or physical health
becomes impaired to such
an extent that they are unable to give their patients an optimum
level of care,they
should swiftly seek and follow appropriate professional advice.
Similarly, if the mental, emotional or physical health of a colleague
becomes impaired to
such an extent that they are unable to give their patients an optimum
level of care, a
member should swiftly bring their concern to the attention of another
colleague,
supervisor or the ARH Ethics and Welfare Director.
5.2 Where trust breaks down
If, for whatever reason, the trust between a patient and member
breaks down to such an
extent that the member can no longer offer an appropriate standard
of care or service,
either the member or the patient may end the relationship. If this
happens, the member
should try to make sure the patient has an alternative source of
homeopathic care if
they want or need it. With the patient’s permission, the member
should provide the new
practitioner with sufficient information to allow responsibility
for care to be handed over
without delay.
6. Complaints and disciplinary procedures
6.1 Complaints
Practitioners trained as homeopaths to ARH standards following
the guidance in this
Code, are able to practise homeopathy safely, competently and ethically.
However, from
time to time something may go wrong.
Patients, members of the public, other professionals and members
of ARH have the right
to complain if they perceive that a member of ARH has not provided
treatment or
conducted themselves in accordance with this Code. Members should
ensure that their patients have clear information about how to express
any concern they may have about
their treatment.
If a patient or other interested party brings an apparent failure
in care to the member’s
attention, they should act promptly and constructively, giving the
matter proper
consideration. The needs of the patient must come first. The member
should give a
sensitive explanation of what has occurred, and take the initiative
to put things right. If
appropriate, the member should offer a suitable apology and an assurance
that steps will
be taken to prevent a recurrence.
Because questions of compensation may arise, the member should
also notify the ARH
Ethics and Welfare Director and the professional indemnity provider
of any steps taken in
response to a complaint brought against them. If a complaint against
a member is taken
to ARH, the member will co-operate fully with ARH’s efforts
to resolve it. If their
conciliation attempts fail, the member must co-operate fully with
the subsequent
Professional Conduct Committee (PCC) proceedings. If a PCC disciplinary
hearing proves
necessary and the member fails to attend, the hearing will proceed
in their absence,
unless sufficient grounds for the hearing to be adjourned have been
provided.
Members have the right to expect support from ARH in the event
of any unwarranted and
unsubstantiated allegations made against them while carrying out
their professional
duties. ARH regards the support of members who have complied with
their ethical duties
as being equally as important as its regulatory function.
6.2 Receiving a Complaint
Ethics and Welfare Director
A complaint received against a member will be passed on to ARH’s
elected Ethics and
Welfare Director (EWD).
The EWD will then contact the complainant in writing to confirm
the allegation received
and to clarify any points that are not clear.
If the EWD feels that the allegation warrants investigation, then
they will contact the
member involved.
If the complaint cannot be effectively conciliated by the EWD liaising
with both parties,
then they will take steps to set up a Professional Conduct Committee
(PCC).
Professional Conduct Committee
The PCC is made up of two Directors of ARH and three members, and
will be constituted
by the EWD. Having appointed the PCC, the EWD will then assume a
role of support for
the member, leaving the PCC to fulfil the function of adjudication.
One of these five people will be nominated as the Chairperson,
who will co-ordinate the
proceedings.
The PCC will:
• establish if there is a complaint to answer
• listen to the evidence available
• decide on an outcome on the balance of probabilities,
and do so on the day of
the hearing, notifying both parties there and then of their decision.
If the complaint is proven, the PCC may impose as a penalty any
of the following:
• Admonishment
• Suspension of membership
• Fine
• Removal from the ARH register.
Once the PCC has come to a decision both parties will be informed
in writing forthwith.
Either party may appeal against the decision within three months
of the date of the
hearing.
6.3 Appeals Procedure
If either party wishes to appeal, they must put their complete
case in writing, including
the full reasons why they consider the PCC decision should be changed.
This will be
considered by a meeting of the Board of Directors who will reach
a decision by simple
majority vote. Both parties will be informed of the Board’s
decision, in writing, as soon
as is practically possible. This decision will be considered final.
|
Forums
Courses
Shop
Diseases
Articles
Journal
Directory
