Massage Therapy Journal Fall 2024

Fall 2024 • 65

The Restroom Access Act varies slightly from one state to another. For example, some states include pregnancy as an eligible condition while other states do not. The Act does not require those with fewer than three employees to let a customer use an employee restroom, as it may leave the store open to damage or theft. Establishments are not liable if a customer sustains an injury while using an employee restroom unless there is evidence of negligence on the part of the business. 71 There is a broad list of medical conditions that cause or contribute to health impairments, 70 so modifying your practice setting according to the condition is important for your clients. Avoid placing potential triggers in your environment. For example, clients with allergies, migraines, asthma and other respiratory issues may find that diffused essential oils trigger medical emergencies. Other clients may be photosensitive and need to avoid blinking or flashing lights. A client with a peanut allergy may react to a therapist’s mid-day snack. Depending on the type of health impairment your client has, it is important to modify the massage according to the client’s medical conditions. A thorough intake process will enable you to learn about any health impairments your clients may have. Mandatory reporting is a legally enforceable duty that requires people who have frequent contact with vulnerable populations to report observed or reasonable suspicions of abuse or maltreatment to state or local authorities. In some states, everyone is considered a mandatory reporter, regardless of profession. Abuse is the knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm. Maltreatment includes neglect, potential harm or endangerment and threatened injury. 72 The Duty to Protect: Mandatory Reporting

Mandatory reporting is based on the principle that a massage therapist’s first and primary duty is to the client. Known as “Duty to Protect,” these laws seek to protect the client’s health and welfare (beneficence) as well as prevent further harm from occurring (non-maleficence). While definitions vary across states, vulnerable people generally include children (under the age of 18), dependent adults (including those with disability) and older adults (over the age of 60). Some states also require that abuse between intimate partners be reported. 73 These laws protect vulnerable people who may be reluctant to report on their own behalf out of shame or fear of retaliation from the abusers. These duties may conflict with a professional’s ethical principles, such as respect for a client’s autonomy or their confidentiality. This conflict is one of the challenges professionals have with the legal obligations of mandatory reporting. 74 History of Reporting Laws An article titled “The Battered Child Syndrome” was published in 1962, and in it the authors discussed the problem of child abuse, ways to identify abused children, and highlighted the need to report serious physical abuse to legal authorities. 75 This was the first time this topic became part of public conversation. The conversation quickly shifted to a social concern and changed the way people in the United States thought about and responded to child abuse. The United States Congress passed the Child Abuse Prevention and Treatment Act (CAPTA) in 1974, which provided funds to individual states for the development of Child Protective Services (CPS) and hotlines to report known or suspected cases of serious injuries toward children. The laws expanded to address sexual and emotional abuse, psychological trauma, neglect and exposure to domestic abuse. Many states have incorporated human trafficking into existing child abuse reporting laws. Over the decades, there has been a huge increase in reporting with enormous numbers

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