Definition: Informed Consent~ permission granted in the knowledge of the possible consequences and the alternatives by a health care provider for treatment with full knowledge of the possible risks and benefits.
Informed consent is based on the legal and moral premise of a person's autonomy, you have the right to make decisions about your own health.
In response to Bill 87, the Ontario governments amendment to the Regulated Health Professions Act (RHPA), the college of Massage Therapists of Ontario (CMTO) has implemented requirements for Registered Massage Therapists (RMT's) to obtain client informed consent for the assessment and treatment of "sensitive" areas. Under the new standards, treatment of sensitive areas of the body must be clinically indicated, assessment and treatment of these areas must be discussed with the client in advance, and written informed consent must be obtained.
RMT's are now to ask clients to sign a consent form for treatment on areas deemed "sensitive" by the CMTO. These include the gluteal region, the inner thigh, the chest wall musculature and the breasts. The CMTO considers these areas at risk of potential misinterpretation and misunderstanding. The client should understand that consent is voluntary and that they can withdraw or alter their consent at any time.
The RMT has the responsibility to explain the treatment including the nature of the assessment and treatment; the clinical reason(s); the draping methods to be used; the expected benefits; the potential risks; and the potential side effects. The RMT can provide the client with the option of a treatment plan that includes treatment of the "sensitive" area, and another option where treatment of this area is avoided.
Draping of these areas should be discussed prior to the treatment. Draping measures set clear boundaries of the areas being treated and the areas not being treated, only the parts being worked on will be exposed. This gives the client a sense of comfort, security, and trust.
Throughout this the RMT is to maintain a therapeutic relationship and work respectfully with the client for the agreed upon treatment plan to meet the client needs and goals with mutual trust and respect. Treatment should always fall within their scope of practice which is 'the assessment of the soft tissues and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissue and joints by manipulation to develop, maintain, rehabilitate or augment physical function and relieve pain.'
An important aspect of the therapeutic relationship is communication. For the RMT it should be respectful, professional and with language the client can understand. The client needs to feel free to express discomfort of any kind to the therapist, and ask questions about things they are not clear about before, during or after the treatment. Communication is important to ensure client comfort and trust.
When you are now asked to sign additional consent forms at Medi-Massage, you will understand the basis for it and that the requirement to do so comes from both the Ontario Governments' Bill 87 with changes to the RHPA as well as the CMTO, the governing body for all RMT's in Ontario.
Thank you for your understanding and support, and as always, we strive to make every visit a wonderful experience.
With that said, I will add this CBC interview with an RMT who shares the views of many massage therapists, just to keep you informed.
