American Chiropractic Association Implements Durable Do Not Manipulate Documentation.....

Arlington, VA- Members of the American Chiropractic Association (ACA) met today at their Arlington headquarters to discuss a variety of concerns regarding withdrawal of futile chiropractic care, the appropriate use of palliative spinal manipulation, and the incorporation of Durable Do Not Manipulate forms into standard practice.

"These are issues that come up regularly in chiropractic clinics across the country," explained Nebraska chiropractor Frank Grimes, who sits on the ACA Chiropractic Ethics committee. "One of the most important items on the agenda was the use of durable documents that help our patients maintain control over their spinal care even when outside of their regular chiropractor's clinic."

The Chiropractic Orders for Scope of Treatment, or COST, is a durable order that documents and directs a patient's chiropractic treatment preferences when faced with life-limiting or irreversible conditions such as Stage 3 WiFi hypersensitivity, malignant adrenal fatigue, or End Stage Candida Overgrowth Syndrome (ESCOS). First developed by the ACA in 2012, the purpose of a COST is to improve end-of-life care by honoring the wishes and goals of patients. COST forms document goals of care obtained during a discussion between a patient, or their health care representative, and their Primary Chiropractic Provider.

A chiropractor discussing the need for a Chiropractic Orders for Scope of Treatment document with a patient

The COST form includes directions about spine-sustaining measures in addition to advanced chiropractic subluxation support (ACSS), such as use of an Activator, manipulation under anesthesia, low level laser therapy and electro-acupuncture. In the event of an emergency, these forms allow for unfamiliar spinal care experts to understand a patient's wishes quickly and easily. But the COST does not take the place of a properly prepared Living Will and Durable Power of Attorney for Spinal Care.