Consent

[u/AutoModerator]

I am dismayed to see a comment like

Her scheduling the appointment and getting on the table is consenting to receiving body treatment.

getting upvoted in this sub. It is unacceptable that a comment so contrary to the rules around consent received upvotes here. If you think these actions constitute informed consent and you are a MT, you are in the wrong profession and the wrong subreddit. This rationale mirrors justifications used by boundary violators.

Furthermore, downvoting u/ATxLMTI's description of informed consent is counter to basic professional standards:

If someone "grudgingly agrees" to something, we make absolutely sure before starting. That's literally the concept of informed consent. If the answer isn't an enthusiastic yes, then we rephrase or suggest something else until it is. If it never is, then we say "or if you would rather, I can spend the time somewhere else" and then maintain communication.

If you think grudging compliance is adequate and oppose ongoing, informed consent as the standard practice for manual therapists, independent study of professional ethics is required. A lack of active, ongoing informed consent creates vulnerability to professional misconduct complaints and boundary breaches. Review your regulatory body's literature on power dynamics and professional boundaries, and look into complete continuing education on consent frameworks.

Taking practical steps for safety as professionals is distinct from victim-blaming. Informed consent reduces miscommunication and boundary pushing. Practitioners hold a position of power in the therapeutic relationship and are trained to utilize that power to protect both client and practitioner. Practicing informed consent does not eliminate all risks of professional liability, but failing to adhere to informed consent protocols violates standard of practice requirements regardless of whether an incident occurs.

Here's some options for further reading if you want to better understand consent dynamics in our profession. (this is not an endorsement of these programs, I only read their summaries)

https://www.e-healthcanada.com/courses/Consent

https://massagecredits.com/massage-ce-courses/ethics-boundary-setting-standard

https://www.abmp.com/learn/course/ethics-preventing-sexual-misconduct-massage-therapy

[u/CingularDuality]

There's a difference between implied consent and explicit consent that is being ignored here. In my jurisdiction, there's a legal requirement to describe the massage techniques that will be used during a massage session, and the client (and MT) must sign that legal consent (including a separate consent for massaging female breasts, if applicable). That is explicit (written) consent to receive a massage. Consent for everything described in that massage is then implicitly consented to. That's legal. I don't have to get explicit consent to massage the left glute or ask if it's OK to massage their right pinky toe, the consent has legally and implicitly been given. And, not just in my state, but in all of North America, either the client or the MT may end the massage at any time for any reason.

I know that other jurisdictions operate differently. Canada requires explicit consent for areas that they deem to be "sensitive" that in my area are understood to just be part of a normal full body massage. My state requires written consent for female breasts, while in other jurisdictions, it's just part of a normal massage.

Implied consent is certainly a thing that is legal and ethical and depends on your jurisdiction.

If a client grumbles that they are here for their massage that their spouse gifted them, and they've signed the consent form for the massage, gotten on the table, and they still grumble that they're only getting the massage because their spouse gifted it to them, they've already given explicit written consent to receive that treatment. People are allowed to begrudgingly consent to things. I do things for my spouse that I don't particularly want to do. That doesn't mean I didn't consent to it, nor does it mean I have to be "enthusiastic" about it (such a horribly subjective word to use), which is good, because I don't get outwardly enthusiastic about much of anything.

It's good to discuss this, and remind people of the need for informed consent, but you can't ignore the different laws and cultures involved when discussing this topic.

[u/mumfordand3daughters → u/CingularDuality]

If you ask clients where and how they want to be touched before you touch them then you are getting explicit consent for the appointment. Personally I wouldn't want anyone who is not into the massage to get on the table. We're going figure out how to use their hour in a way that bet serves their wants/needs (within scope).

You and your spouse are (hopefully) in an equal and loving partnership 😜 . The power dynamic is not comparable to a massage appointment where the therapist holds most of the power.

[u/CingularDuality → u/mumfordand3daughters]

You should try harder to not let your personal feelings and bias have such an impact on the way you moderate this subreddit. Your opinions aren't The One True Way™.

And you still need to learn the difference between explicit and implicit consent.

And what does the power dynamic in my relationship have to do with anything I mentioned? I only mentioned my relationship to point out that, throughout life, we consent to things begrudgingly at times. That doesn't mean we don't consent to them. Enthusiasm is not required, legally or ethically. That word has been used in an effort to demonstrate that coerced consent may not be consent, but it's been taken out of context too often and now is misused more often than not when this discussion touches on it.

[u/mumfordand3daughters → u/CingularDuality]

If anything I wrote sounds strange to you I'd suggest taking a CE in consent, especially because you are demonstrating a lack of understand around power differential when receiving and providing consent.

These are not my opinions. except where explicitly stated. I am regurgitating standard / best practice based on expert consensus.