Reaching Beyond Our Borders

Chiropractors have an ethical obligation to enhance and protect public health.

By Stephen M. Perle, DC, MS

“Doctors of chiropractic should conduct themselves as members of a learned profession and as members of the greater healthcare community dedicated to the¬ promotion of health, the prevention of illness and the alleviation of suffering. As such, doctors of chiropractic should collaborate and cooperate with other healthcare professionals to protect and enhance the health of the public with the goals of reducing morbidity, increasing functional capacity, increasing the longevity of the U.S. population and reducing healthcare costs.” ~ Tenet X, ACA Code of Ethics

Looking back at chiropractic’s more than 110-year history shows that our profession has withstood many great struggles, and made both good and poor choices. One of our profession’s historical failings has been its lack of involvement in the broader public health community.

Certainly, the AMA boycott had an impact on chiropractic’s ability to reach beyond its borders. Nevertheless, this shortcoming was rectified in 1995 with the creation of the American Public Health Association’s (APHA) Chiropractic Health Care Section. The creation of the APHA section is in keeping with our moral duty as a learned profession to promote health, the prevention of illness and the alleviation of suffering--which extends beyond the doors of our offices to the community at large. 

Chiropractors have always been concerned with issues beyond the spine, but generally our reach has been limited to our own patients. We were among the first health professions to talk about the importance of a good diet and exercise, and we have always been concerned about the quality of life, not just the quantity. The word “doctor” comes from the Latin docere, which means teacher. As doctors, our duty to teach means that we must help educate everyone about how to live a healthier lifestyle.

From looking at the goals and objectives of the U.S. Department of Health and Human Services’ Healthy People 2010, it’s evident that our profession has a significant role to play in this important public health initiative:

• Goal 1: Increase Quality and Years of Healthy Life—I mentioned above our concern for increasing quality of life, as well as the length.
• Goal 2: Eliminate Health Disparities—Our profession has always provided health care to those who could not afford it. Likewise, some of our peers practice in small communities where other health professionals refuse to practice, thus providing access to health care for more citizens. 

There are a  total of 28 objectives in Healthy People 2010; many of them are a natural fit for chiropractic. The second objective is concerned with arthritis, osteoporosis and chronic back conditions. The objectives related to nutrition and physical activity also are clearly within our scope and historical concern. And those dealing with substance abuse and tobacco befit our profession’s drug-free approach. 

I encourage everyone to take a look at Healthy People 2010 (and soon, Healthy People 2020) at http://healthypeople.gov.

Each of us has a moral duty to join in the public health efforts outlined in Healthy People 2010. We can do this as individuals…or join with our colleagues at APHA to help achieve these goals and objectives.

Dr. Perle is a professor of clinical sciences at the University of Bridgeport College of Chiropractic, where he has taught an ethics course for more than 15 years. To read ACA’s entire code of ethics, visit www.acatoday.org/ethics. Send questions to ethics@acatoday.org.