A new study from Clinical Compass has identified significant variations in informed consent requirements for chiropractors across U.S. state, district, and territory licensing jurisdictions. While informed consent has been a standard in healthcare since 1905, this study reveals inconsistency in the implementation of informed consent process in chiropractic care across the U.S.
The research, which reviewed all 50 states, one federal district, and five U.S. territories, found that most jurisdictions (82%) do not specify a required format for informed consent, and many do not provide detailed guidance on what should be included in the consent process. However, a small group of jurisdictions—such as North Carolina and Oregon—offer more comprehensive recommendations, incorporating key elements of the PARQ framework (Procedures, Alternatives, Risks, and Questions).
Although the study highlights positive steps toward ensuring patients are informed about the risks of chiropractic treatments, it also underscores the need for greater consistency across the country. Many jurisdiction websites still lack clear regulations or guidelines for informed consent, leading to uncertainty and variation in chiropractic practices.
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The study calls for concerted efforts to standardize informed consent processes to promote a culture of patient safety and to ensure clearer communication between chiropractors and patients nationwide.
This paper is available open access (for free) on the journal website: CLICK HERE Please read it and share it with stakeholders in your local region.
Full press release here.
Clinical Compass is an evidence-synthesis research collaborative that generates reviews and best practices research through consensus-based models. In addition, Clinical Compass maintains regularly updated evidence centers for 17 different clinical topics such as dry needling, opioids, and cost-effectiveness. To support the work Clinical Compass, please go here: Donate – The Clinical Compass
Citation: Daniels CJ, Paris D, Mooring S, Anderson K, Crivelli L, Muth C, Clinical Compass. United States guidance on informed consent for chiropractors: a review of state regulator websites. Journal of Contemporary Chiropractic 2025;8(1):135-143.
