ŠKunz and Kunz 2003
Massage Regulation of Reflexology
The inclusion of reflexology services as a part of massage regulation creates conflict with existing laws and existing norms of professional performance, specifically raising questions about: (1) First Amendment Rights, (2) criteria for professional licensure, (3) full and fair disclosure system, (4) public safety issues, (5) criteria of a professional practice, (6) standards for establishing a professional scope of practice, (7) standard of practice for a profession, and (8) certification of competence over a professional field.
1. First Amendment Rights
In 1917, the New York State Supreme Court found that a Christian Scientist had a constitutionally protected right to seek the health services of his or her belief choice and that the accused individual was not violating the state's Medical Practices Act of 1906. In a Board of Medical Quality Assurance Report (BMQA) of 1982, the authors note that a practitioner of alternative health services is protected by the same constitutional right in providing his or her services.
See Board of Medical Quality Assurance Report , 1982, State of California, p. 17.
Massage regulation of reflexology: The Constitutional, First Amendment Rights of reflexologists have been abridged by massage regulation of their profession. In order for such abridgment to take place, it must be shown that there is an overriding public safety issue. The public safety issues of reflexology and massage are not the same. Reflexology's concerns are practicing medicine without a license and fair practices issues (receiving the service one is promised). The two public safety issues of massage practice are nudity and therapeutic claims.
2. Criteria for licensure from a state legislature
Specific criteria exist when a legislative body considers regulation of a profession. Criteria include concerns such as those expressed in a recent New Mexico state document:A. Public safety
B. Economic hardship
C. No alternative to licensing will protect the public.
D. The profession is clearly different from those already licensed.
E. The profession require specialized knowledge.
F. The public will benefit from assurance from the state of initial and continuing competence. The public cannot be effectively protected in any other way.
(State of New Mexico, Sunrise Act (12-9A-1 to 12-9A-6 NMSA 1978)
Massage regulation of reflexology: By including reflexology in the scope of practice of massage, criteria normally applied to licensing a profession are ignored. Public safety concerns are increased, economic hardship is created, the reflexology scope of practice is defined by those who are not professional reflexologists, and the public not benefit benefit from better solutions such as a full and fair disclosure of services and providers. (See below.) In addition, such laws raise questions about antitrust issues and economic advantage being given to one group over another.
3. A full and fair disclosure system
The liability concerns of the reflexologist could be better met by a full and fair disclosure system. The consumer would be presented with a full and fair disclosure of the individual practitioner's education and service. A fully informed consenting adult would the make a decision in the purchase of services. An example of such a system is included in the Board of Medical Quality Assurance Report, State of California, November 1982, p. 19
Massage regulation of reflexology: Since the law does not include a definition of reflexology practice or training requirements for a practitioner, the consumer cannot make an informed decision in the purchase of services. It could be argued that the state is increasing the liability to the consumer seeking reflexology services.
4. Public safety
Public safety issues are met by the assurance that, when licensed, practitioners practice within the legally defined, legislatively-mandated and licensed scope of practice, "confining their work to those (activities) that they are trained to do." (Durnoff, Michael, ed. Michael H. Cohen, "Malpractice Liability of Alternative / Complementary Health Care Providers, A View from the Trenches," Alternative & Complementary Therapies Journal, June/July, 1995, pp. 248-253)
Massage regulation of reflexology: Since no reflexology training is required, public safety is not assured legally mandated practitioners are not trained in reflexology and public safety issues inherent to its practice. Can the consumer be assured of practitioner competence in the providing of reflexology services?
5. The criteria for a profession
(from a sociologist's viewpoint):A. Systematic body of theory
B. Professional authority
C. Sanction of the community
D. Regulative code of ethics
E. The professional culture
(Schneider, Jill, "A Definition of a Profession and Some Notes Pertaining to Reflexology," Reflexions, Vol. 14, No. 1, Spring/Summer, 1993; Reflexions, Vol. 15, No. 1, Winter/Spring, 1994, p. 6)
Massage regulation of reflexology: Such laws create unknown professions. Where are the texts that educate the reflexologist and where are the above-listed attributes of the reflexology profession as described in the Alabama state massage law?
6. Scope of practice
Licensing laws define the legal scope of practice &emdash; the area of expertise &emdash; being regulated. Massage law definitions are vague and unconstitutional in language. They serve two purposes: (1) to certify the competence of massage practitioners and (2) to discourage the practice of prostitution. The massage profession includes the regulatory concern of meeting anti-prostitution concerns inherent to the nude bodywork practice of massage.
(See "Criteria for a profession" above.)
Massage regulation of reflexology: The Alabama massage law includes a 170-word definition of massage practice. The definition does not describe any known profession. Does the law certify individuals to be competent over an unknown profession? Where is the systematic body of knowledge over which the professional is trained to practice the profession described in the Alabama state law?
Under massage laws regulation, reflexologists, providers of a non-nude service, are required to meet the increased requirements and cost incurred by individuals who practice a nude service. Such costs are passed on to the consumer as higher costs for the reflexology service.
7. Standard of practice
Foot work practices have been created in cultures around the world since ancient times. However, there is no known direct descent of a footwork system carried on continuously since ancient times. The modern-day practice of reflexology is a direct descendant of medical research into the reflex at the end of the nineteenth century in Europe. A variety of therapeutic methods was created to influence the body through the reflexes. One resulting therapy was the work of Dr. William Fitzgerald of Connecticut who created zone therapy, application of pressure to all parts of the body, following a visit to England. His work was gradually developed by Dr. Riley and Eunice Ingham into the foot work known today in America as reflexology.
An established standard of practice has been accepted by the reflexology profession as represented by the professionals organizations, Reflexology Association of America and the American Reflexology Certification Board. It is: "Reflexology is the physical act of applying pressure to feet and hands with specific thumb, finger, and hand techniques that do not utilize cream, lotion of oil, assessed on the basis of zones and reiterative areas with the premise that such work effects a physical change in the body."
(Reflexions, Vol. 15, No. 1, Winter/Spring, 1994, p. 10)
Massage regulation of reflexology: By what authority has the attorney general created a standard of practice for the profession of reflexology? What criteria were used? What professional associations set the standards of practice for the reflexology professional described in the Alabama state law?
8. Criteria for certifying the competency of a professional
Established standards describe the requirements in certifying the competency of an individual within the bodywork professions. A 1996 report by the Reflexology Association of America Education Committee notes finding that 30 of 31 certifiers of competency in bodywork require: (1) completion of a course of study, (2) in a specific curriculum, (3) in a specific number of hours. (Education Committee Report of January 3, 1996, Reflexology Association of America)
Massage regulation of reflexology: Massage laws set no educational standards for reflexology, a service provided separately from massage. Massage laws provide for substandard certification of reflexology service providers. © Kunz and Kunz, 1997
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