Speaking Mindfully: The Legal Implications of Health Advice, Part I

Although students often ask yoga teachers and studios for health advice, legal and ethical rules can affect the way such questions can be answered. Here's how to understand some of the legal implications of requests by yoga students for health advice.

By Michael H. Cohen, JD, MBA

Imagine this scenario: before beginning a class, you ask whether any of your students are pregnant or injured so that you can design the class appropriately for their needs. But instead of giving you a simple description of their concerns, several students ask complicated health-related questions.

Three students have questions: the first is healing from whiplash and wonders whether Shoulderstand or Headstand could possibly compromise her chiropractic sessions; the second has asthma and asks about the potential benefits of these postures for his condition; the third has a heart condition and heard from his energy healer that "turning upside down could reverse the energy flow and spin the heart chakra backwards." You deflect these questions by muttering, "well, then, maybe skip the pose." Then, after class, a fourth student asks whether certain Chinese herbs are helpful for menopause and another wonders whether acupuncture can help augment flexibility.

How can you appropriately respond to all of these students, especially given the wide range of questions that they have? How can you maintain a boundary between your area of expertise—yoga teaching—and the health professions?

The boundaries are blurred, and for a reason. First of all, yoga has always been a healing discipline. In fact, historically, yoga was transmitted one-on-one, because this form of teaching allowed the teacher to be attentive to the student's individual needs regarding both spiritual and physical health. In fact, yoga masters prescribed specific yoga poses to treat various ailments. Of course, today yoga teachers are rarely trained in that level of expertise.

And even if they were, U.S. licensing laws restrict who can give certain kinds of health advice. In the late nineteenth century, organized medicine in the U.S. increased standards for medical education and practice, enhancing the profession's quality and stature, but also marginalizing many forms of holistic health care. States passed medical licensing laws, conceptualizing all healing as "medicine" and making the unauthorized practice of medicine a crime. Chiropractors, naturopaths, massage therapists, and other healers were jailed.

Decades later, these professions achieved licensure for their own members. Even so, while physicians have "unlimited" legal authority to diagnose and treat disease, non-medical professionals must operate within a more limited scope of practice that is delineated by statutes and regulations. For example, in the allied health professions, licensure to practice psychology or physical therapy only authorizes diagnostic and therapeutic work related to mental health and physical rehabilitation respectively; similarly, other healers are limited to modalities specific to their professional training. For example, licensing law definitions in many states allow chiropractors only to use spinal manipulation to readjust the flow of "nerve energy" in their patients; acupuncturists to use traditional oriental medicine to adjust the "flow and balance of energy in the body;" and massage therapists to engage in "rubbing, stroking, kneading, or tapping" the muscles to promote relaxation and create well-being.

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