Ethical Issues
In our society, two of the concepts that distinguish professionals from nonprofessionals are accountabilityand liability.  To be accountable means to be subject to giving an account or an explanation of one’s actions.  To be “liable” means to be responsible and obligated according to law or equity.  The term “professional liability” means the obligation of the professional to pay for damages resulting from his or her acts during contact with clients.  Another important hallmark of being a professional is the understanding and application of theoryto the work. 
When a theory becomes generally accepted and firmly established, it becomes a doctrine or a fundamental principle.  Since humans first began to think and reflect, they have developed theories about what causes health, illness and healing, and how we should interact with those phenomena.  Today there are thousands of theories based on the values, perspectives and experiences of thousands of groups of people.  The development of a professional theory starts with examining one’s own personal theories, perspectives, experiences and values and extends to the theories that are accepted and approved by one’s professional group or subgroup.  
When a group of people want to establish themselves as professionals, one of the first things they do is define their work, or practice.  In relation to healthcare professionals, Taber defines practice as “the use of knowledge and skill to provide a service in the prevention, diagnosis and treatment of illness, and the maintenance of health.”  Each profession eventually establishes, through arduous member discussion, a “Standards of Practice” statement.  A standard is something established by authority, custom or general consent as a model or example. Therefore, Standards of Practice are the baseline criteria for acceptable practice. Standards of Practice serve several functions. They inform new members about the group’s expectations and they inform the public, other professionals, businesses and regulatory agencies about the responsibilities they can expect from the group setting standards is an important step toward professionalism.  Following are the Yoga Alliance Code of Conduct.

Yoga Alliance Code of Conduct
Our code of conduct is a declaration of acceptable ethical and professional behavior by which all registrants agree to conduct the teaching and business of yoga. It is not intended to supersede the ethics of any school or tradition but is intended to be a basis for yoga principles. As a RYT, E-RYT or representative of a RYS, I agree to uphold the following ethical principles:

  • Conduct myself in a professional and conscientious manner.  This includes, but is not limited to, ensuring that I live up to any commitments I make to my students or to the public, and ensuring that my practices and behavior conform to the representations I make about myself in holding myself out as a yoga practitioner who adheres to certain precepts.
  • Acknowledge the limitations of my skills and scope of practice and where appropriate, refer students to seek alternative instruction, advice, treatment or direction.
  • Create and maintain a safe, clean and comfortable environment for the practice of yoga.
  • Encourage diversity by respecting all students regardless of age, physical limitations, race, creed, gender, ethnicity, religion or sexual orientation.
  • Respect the rights, dignity and privacy of all students.
  • Avoid words and actions that constitute sexual harassment or harassment based on other legal protected characteristics.
  • Adhere to the traditional yoga principles as written in the yamas and niyamas.
  • Follow all local government and national laws that pertain to my yoga teaching and business.

I understand that Yoga Alliance Registry may revoke my right to use the Registry Mark for cause, including failure to uphold the standards set forth in the code of conduct.  Prior to revoking my right to use the Registry Mark, Yoga Alliance Registry will provide me notice of the basis for the potential revocation and an opportunity to respond in writing.  After review of the evidence, Yoga Alliance Registry will issue a decision as to whether to revoke my credentials, based on its reasonable judgment of the evidence before it.  I agree to hold Yoga Alliance Registry harmless for any losses or damage I may incur as a consequence of the revocation of my credentials.

Professional Code of Ethics
Yoga Therapists and yoga teachers have an ethical and legal responsibility not to harm their clients. However, humans vary greatly in their beliefs, so how are we to come together in a group and agree on priorities, values and other beliefs?  Hopefully, this can occur through a written code of ethics.  For our purposes, ethics is defined as “a set of moral principles or values; declarations of what is right or wrong and of what ought to be.” According to this definition, our ethics show themselves through our conduct and actions.  A professional Code of Ethics is a collection of rules, regulations and/or specifications for governing professional conduct. Each professional group creates its own Code of Ethics to define what actions are good and bad, and where moral duty and obligation fall. A Code of Ethics usually specifies the relationship of the practitioner to the client, to fellow practitioners and to society at large. The code may be written, unwritten, or both.  The Code of Ethics for the International Association of Yoga Therapists (IAYT) is a good example.

The International Association of Yoga Therapists (IAYT) Code of Ethics

Preamble
Yoga therapists who are members of IAYT, including IAYT-certified yoga therapists and yoga therapists involved in training programs, must be committed to responsible and ethical practice, to their own professional and personal growth, and to contributing to the growth and development of the field of yoga therapy. In furtherance of these commitments, they agree to be bound by the following code of ethics.

A. Commitment to the Client or Student
I Will...
1. Respect the rights and dignity of each client or student.
2. Provide my services in a nondiscriminatory manner.
3. Keep the client informed by explaining practices and recommendations and making only realistic statements regarding the benefits of yoga therapy.
4. Protect the confidentiality of information acquired in the course of client care.
5. Maintain professional boundaries and relationships with clients or students and avoid any relationships that may exploit practitioner-client or teacher-student trust.
6. Keep accurate records of each clients history and treatment.
7. Treat only within the level of my skill and knowledge.
8. Provide the highest quality of care and make timely referrals to other healthcare professionals as appropriate.
9. Refrain from treating clients if I am unable to safely and effectively treat due to substance abuse, physical, and/or psychological impairment.
10. Seek appropriate assistance for any personal problems or conflicts that impair my ability to practice.
11. Bill clients and third-party payers accurately and fairly.
12. Either receive or pay a commission for referral of a client.
13. Not initiate sexual contact with a current client or student after the practitioner-client or student-teacher relationship is established.
14. Be mindful that engaging in sexual contact with a former client or student can cause egregious harm and me be exploitive of the trust established during the professional relationship due to the inherent power imbalance involved in the practitioner-client or teacher-student relationship. Therefore, I will exercise extreme caution in entering into any type of personal relationship with the former client or student.

B. Commitment to the Profession
I Will...
1. Work to promote high standards for the profession.
2. Provide accurate, truthful and non-misleading information in connection with any I Y A T application, requirement or disciplinary investigation or proceeding.
3. Comply with all IAYT policies that pertain to my membership and certification status.
4. Stay abreast of new developments in the field of yoga therapy through educational activities and study.
5. Not malign colleagues or other professionals.

C. Commitment to the Public
I Will...
1. Provide accurate information regarding my education, training and experience, professional affiliations and certification status.
2. Use only appropriate professional designations of my credentials, including any designations required are granted by the IAYT.
3. Advertise only accurate, truthful, non-misleading information and refrain from making public statements on the efficacy of yoga therapy are not supported by the generally accepted experience of the profession.
4. Respect the integrity of other forms of healthcare and other health and wellness traditions, and seek to develop collaborative relationships to achieve the highest quality of care for individual clients.

Statement of Ethics

Yoga is a system of self-investigation, self-transformation and self-realization. It's practices and lifestyle aim to integrate the body, mind, heart and spirit and awaken students to their innate wholeness. The yoga therapist aims to nuture the physical, emotional, psychological, social and spiritual well-being of clients.

Statement of Purpose

This statement of Ethics guides yoga therapists in their work of supporting clients' well-being through yoga practice. It is based on the traditional yogic ethical principles, the yamas and niyamas, as outlined in Patanjali's yoga sutras. This Statement of Ethics reflects the timeless, living principle that our essential nature is awake, aware, compassionate and peaceful.

1. Ahimsa - Nonviolence and Compassion: As yoga therapists, we seek to do no harm to others and to act with care and compassion.

2. Satya - Truthfulness: As yoga therapists, we act truthfully at all times.

3. Asteya - Not Stealing: As yoga therapists, we take only what is rightfully ours.

4. Brahmacharya - Self-Restraint in the Path to Wholeness: We recognize that the therapist-student relationship exists to serve the deepest goals of well-being through yoga. Thus, we practice self-restraint and direct our energy and actions toward these deep aims.

5. Aparigraha - Non-Clinging: As yoga therapists, we practice the practice the principle of non-attachement and generosity and we welcome change, acknowledging the natural abundance of life.

6. Saucha - Purity: As yoga therapists, we cultivate purity of body, mind and environment. This includes fostering clarity of intention, ongoing self-care, and a clean environment for the practice of yoga therapy.

7. Santosha - Contentment/Happiness: As yoga therapists, we practice an active acceptance of the present, thus developing deep happiness.

8. Tapas - Discipline: As yoga therapists, we are dedicated to a disciplined and committed yogic lifestyle.

9. Svadhyaya - Self-Study: As yoga therapists, we are committed to on-going self-reflection and continued learning.

10. Ishvara Pranidhana - Relationship with Wholeness: Our aim as yoga therapists is to serve the deepest goals of yoga. We honor and encourage an on-going relationship with innate wholeness and oneness with all of life.

Case Study #1 - Confidentiality

John Doe, Yoga Therapist and Jane Jones (therapy receptionist) are in a private Yoga Therapy office discussing the fact that they are treating Joe Superstar, an NFL quarterback.  John says, “I can’t believe that I’m actually treating Joe Superstar.”  Jane asks, “How bad do you think his injury is?”  John replies, “I saw his MRI report, I think he is going to need surgery.”

Is this a breach in confidentiality?

The information contained in each patient’s medical record must be safeguarded against disclosure or exposure to nonproprietary individuals.  The right to know any medical information about another is always predicated on a sound demonstration of need.  Frequently, many individuals require access to information contained in a patient’s medical record. Their right to access this information is limited to only that information which is deemed necessary for them perform their job in a safe, effective, and responsible manner.

The first questions we must ask are “What information is being disclosed and does the individual engaged in the conversation have a need to know this information?”
John’s first statement discloses the name of person receiving care, and his second statement reveals private patient medical information.  Certainly, as the therapist, John would need to know the patient’s name and therapy related diagnostic imaging in order to provide proper care.  Therefore, the disclosure to Jane of the patient’s private medical information is a breach of patient confidentiality. 

Case Study #2 – Qualifications of Practice

You work in very busy yoga therapy practice. The receptionist is a yoga therapy student who is almost completed with her training. A potential client comes in and you are booked with a session. The receptionist decides that she will perform the yoga therapy since she knows she can give the client a professional yoga therapy session.

Is the practice providing ethical care to this client?

The practice of yoga therapy, although not regulated throughout the United States, relies on the personal ethics of each practicioner. Therefore, it is each person's responsibility to adhere to certain standards of care. The therapist must also ensure that all care provided not directly by them, but under their supervision, also meets these standards.

In this situation, the receptionist’s abilities are considered irrelevant.  The key issue here is that the receptionist is a student and is not yet fully trained to practice yoga therapy.

Case Study #3 – Privacy

John Doe is a yoga therapist working in private practice. His yoga client Jane Smith removes her coat and reveals a bikini top and bottom that barely covers her. During the session, John is constantly distracted by Jane's revealing clothing.  Jane is aware of this and tries to cover herself with her hands during the session.

Is this a breach of client privacy?

Yes. The yoga therapist must insure that the client's clothing is appropriate so that both the he and the client feels safe and comfortable at all times.

Case Study #4 – Acknowledge Limitation and Contraindications
Jane Doe is a yoga therapist at a spa in a country club. A member of the country club comes into the spa for a yoga therapy session. He has just played golf and is feeling pain in his shoulder, which he wants Jane to assess and provide yoga therapy. As Jane begins to assess his shoulder, the member is wincing in pain, but insists that she continue.  His shoulder is swollen, warm and red.  Contrary to her better judgment, Jane continues to provide yoga stretches for his shoulder.

Is Jane honoring her ethical commitment?

No. Jane should realize that acute inflammation is a contraindication to yoga therapy and either work around the acutely injured area or refer the client for medical assessment.

Case Study #5 – Conflicts of Interest
John Smith, yoga therapist, works in a chiropractic clinic.  He is meeting with a vendor whose company is introducing a new line of yoga props onto the market.  The vendor offers him a free case of straps  to “try out” with patients. The vendor states that if John continues to order more straps, he will qualify to receive compensation from his company by automatically becoming a member of its National Yoga Therapy Panel.

Does this represent a conflict of interest?

Yes, there exists a conflict of interest in this situation.  John has two primary obligations to fulfill.  The first is to his client. It is his professional duty to use the best props for his clients. The second obligation is to his employer, the chiropractic clinic.  As an employee, it is his responsibility to manage expenses by thoroughly and objectively seeking effective products that also demonstrate economic efficiency.  The conflict of interest occurs when he begins to accept compensation from the vendor in direct or indirect response for his orders.  Even if he truly believes these are the best props for his clients, and these are the most cost effective straps that the clinic could purchase, by accepting the money he has established at least an apparent conflict of interest.  Under this situation he is obligated to disclose to all parties his financial interest in ordering the lotion. This disclosure is necessitated because the potential for personal gain would make others rightfully question whether his objectivity was being influenced.
A conflict of interest is a situation in which a person has a private or personal interest that influences the objective exercise of his or her professional duties. As a professional you take on certain responsibilities and obligations to clients, employers, and others. These obligations must take precedence over a therapist’s private or personal interests.
In addition to avoiding all real instances of conflict of interest, therapists must also avoid any apparent or potential conflicts as well.
An apparent conflict of interest is one in which a reasonable person would think that the professional’s judgment is likely to be compromised, and a potential conflict of interest involves a situation that may develop into an actual conflict of interest.
How do you determine if you are in a conflict of interest, whether actual, apparent, or potential? The key is to determine whether the situation you are in interferes or is likely to interfere with your independent judgment. A good test is the ‘trust test’: Would relevant others (my employer, my clients, professional colleagues, or the general public) trust my judgment if they knew I was in this situation. Trust is at the ethical heart or core of this issue. Conflicts of interest involve the abuse, actual or potential, of the trust people have placed in professionals. This is why conflicts of interest can not only injure particular clients and employers, but they also damage the whole profession by reducing the trust people generally have in therapists.

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