Standard of Practice: Consent

Patient Outcome

The patient receives the information they need to make an informed decision about their care and is given the opportunity to ask questions of their RMT/MT. Assessment and/or treatment only begins after the patient has given the RMT/MT consent. The patient is aware they can withdraw their consent at any time.

Registered Massage Therapist Outcome

The Registered Massage Therapist/Massage Therapist (RMT/MT) obtains informed consent (from patients or their substitute decision-makers) prior to and throughout assessment and treatment.

Requirements

The RMT/MT must:

1. Obtain the patient’s consent prior to conducting an assessment, providing treatment, or modifying a treatment plan. Consent must include a discussion with the patient about the following six elements:
   1. The nature of the treatment;
   2. The expected benefits;
   3. Risks and side effects;
   4. Alternative courses of action;
   5. Likely consequences of not having treatment; and
   6. The patient’s right to ask questions about the information provided and that assessment or treatment will be stopped or modified at any time at their request (see also the Standard of Practice: Collecting Health Information from Patients).
2. Obtain the patient’s informed consent (written or electronic) prior to every assessment and/or treatment of sensitive areas including the upper inner thighs, chest wall muscles, and the breasts. The RMT/MT must not touch the breasts except when assessing and/or treating the breast if the patient has requested that for a clinically indicated reason (for example, surgical intervention or perinatal care). The RMT/MT must also obtain informed consent (written or electronic) prior to assessing and/or treating the buttocks (gluteal muscles) at the first visit in a treatment plan, then verbally prior to every treatment within that same treatment plan (see also the Standard of Practice: Prevention of and Zero Tolerance for Sexual Abuse).
3. Ensure that consent relates to the assessment and/or treatment being proposed, is given voluntarily, and not obtained through misrepresentation or fraud.
4. Confirm the patient who is providing consent is capable. If the patient is incapable, then a substitute decision-maker can provide consent on behalf of the patient. If a patient is incapable and no substitute decision-maker is available, RMTs/MTs must refuse to provide assessment and/or treatment.
5. Use professional judgement to determine if the patient can understand the potential benefits and risks of Massage Therapy treatment as explained, and whether the patient’s perception of pain or pressure levels, or indeed of what occurred during the treatment itself, could be impacted, if the RMT/MT believes the patient has used an impairing substance (e.g., cannabis or alcohol).
6. Not use or sell any modality or product (including topical products and lubricants) about which the RMT/MT lacks sufficient information about its risks, benefits, and contraindications. Without this information, the RMT/MT cannot obtain valid consent and so must not use the modality or apply the product during treatment.
7. Not use or sell topical cannabis products (whether provided by the patient or the RMT/MT) during Massage Therapy treatment. Current research does not address the risks, benefits, and contraindications of such products; without this information, the RMT/MT cannot assess the risk to the patient, informed consent cannot be obtained, and the product must not be applied.
8. Monitor the patient throughout assessment and treatment and, when appropriate, reverify consent.
9. Document consent conversations in the patient health record within 24 hours of the appointment at which consent was obtained. When the RMT/MT obtains written or electronic consent for assessment and/or treatment of sensitive areas, it must also be kept in the patient’s health record.

Bolded terms are found in the Glossary.