Risks come with almost every medical procedure you can think of. Some of the risks are minor – like transient pain or swelling. Other risks can be major, like paralysis, stroke, or even death.
Medical providers must get informed consent before providing elective treatment. This requirement applies not only to doctors but to all medical professionals, chiropractors included.
For people receiving chiropractic care in Ontario, understanding consent is an important part of making informed decisions about their health.
What Is Informed Consent?
Before undertaking the elective treatment of a patient, a medical practitioner has a duty, without being questioned, to provide adequate information to the patient. This involves disclosing the nature of the proposed treatment and any material, special, or unusual risks of the treatment.
Where more than one viable option to manage the patient’s medical condition is available, the patient is also to be informed of the relative and comparative risks and benefits between the options. (Denman v. Radovanovic, 2024 ONCA 276 at para 45)
This is called informed consent.
If a healthcare provider treats a patient without informed consent and the patient is injured as a result, the patient may have a legal claim even if the treatment itself was otherwise performed properly.
How Do You Prove a Lack of Informed Consent?
At court, when informed consent is involved, it is the plaintiffs job to prove that the information was inadequate.
In addition to this, the plaintiff must also be able to prove that:
- They would not have undergone the procedure had they been adequately informed, and
- A reasonable person in the plaintiff’s position would not have undergone the procedure if given adequate information
(Denman v. Radovanovic, 2024 ONCA 276 at para 47)
These requirements are important because courts do not simply ask whether information was missing. They also consider whether that missing information would have changed the patients decision.
How Does Informed Consent Apply to Chiropractic Treatment?
Like any medical treatment, chiropractic treatment comes with risks.
Some of those risks can be minor, such as temporary soreness of discomfort following an adjustment. Others, while uncommon, can be much more serious, including stroke, disc injuries, or neurological complications. (
Before proceeding with treatment, the chiropractor must disclose:
- the nature and risks of the proposed treatment
- inform you about the comparative risks and benefits of all treatment options
Doing nothing is one of the treatment options that typically must be discussed.
The requirement of informed consent is also set out in the Standards of Practice for Ontario Chiropractors.
The Case of Glazier-Goldie v. Arsenault
Glazier-Goldie v Arsenault, 2023 NBCA 5 is a New Brunswick Court of Appeal case involving chiropractic informed consent.
Mr. Arsenault suffered severe neurological deficits following a stroke which he alleged was caused by his chiropractor, Dr. Glazier-Goldie.
The matter went to trial and the Trial Judge found that the chiropractor:
- did not obtain informed consent
- the chiropractic treatment caused the stroke.
The chiropractor appealed. The Court of appeal upheld the Trial Judge’s decision.
A key issue was that Mr. Arsenault was reluctant to sign the consent form. He asked the chiropractor about the risk of stroke. He remembered the chiropractor suggesting that he wasn’t at risk of stroke because of his age and health. The chiropractor didn’t remember the conversation.
The evidence also showed that the chiropractor failed to discuss reasonable alternative options, despite some being available.
The chiropractor also didn’t present Mr. Arsenault with reasonable treatment alternatives, even though they were available.
The Court ultimately concluded that:
- Arsenault wouldn’t have undergone neck manipulations if he were adequately informed
- A reasonable person in his position would likewise have declined the treatment
The case serves as an important reminder that obtaining informed consent requires more than presenting a form for signature.
What Questions Should You Ask Before Chiropractic Treatment?
If you are considering chiropractic treatment, it may be helpful to ask questions such as:
- What are the risks associated with this treatment?
- Are there alternative treatment options available?
- What are the benefits and risks of those alternatives?
- What could happen if I choose not to proceed with treatment?
- How common are the risks being discussed?
Patients should feel comfortable asking questions and ensuring they fully understand the proposed treatment before consenting.
Should I Still go to the Chiropractor?
Chiropractors can be important members of your care team, and many patients find chiropractic treatment helpful for managing pain and improving mobility.
However, like any medical treatment, chiropractic care comes with risks.
It is always a good idea to have a conversation with your chiropractor about the risks and benefits of treatment and make sure you’re fully informed before you agree to proceed. Make sure all your questions are answered and don’t hesitate to get a second opinion from another chiropractor, or your medical doctor.
Being fully informed allows you to make the healthcare decision that is right for you.
Injured After Chiropractic Treatment?
If you’ve been injured in the chiropractor’s office in Ottawa, or anywhere else in Ontario, one of the issues that may need to be examined is whether proper informed consent was obtained before treatment was provided.
Depending on the circumstances, you may have legal options available.
If you or a loved one has been injured in Ontario and would to discuss whether informed consent was properly obtained, contact Bergeron Clifford Injury Lawyers for a free consultation. All we do is injury law, serving Ottawa, and communities across Eastern Ontario.
