Pre-existing Medical Conditions and Injuries
Yoga studios and teachers are often faced with the question of how they should teach students who have pre-existing medical conditions or injuries yet avoid subjecting themselves to an increased risk of liability for personal injuries sustained by students. (I will use “condition” to refer to both medical conditions such as diseases and pain as well as physical injuries.)
Should a teacher inquire before class if any students have a condition or should a teacher not make any inquiry at all? If a teacher makes an inquiry, how should the teacher use that information to guide the student in class? How should a teacher respond if he or she does not inquire but a student volunteers information about a condition? What if the student has an open and obvious condition such as pregnancy?
The answers to these questions may vary for different practices such as hot yoga, power, pre-natal, therapeutic yoga and private lessons.
A related issue is whether yoga studios and teachers should request medical information in new student sign-up forms or private lesson intake forms. If so, what risks and obligations does the collection of this information create?
These questions are further complicated because they may involve conflicts between our yogic and legal responsibilities. How do we balance our duties of ahimsa (non-violence), compassion and caring against our interest in avoiding legal liability for aggravating a pre-existing condition?
Summary of Best Practices
Below is a summary of the best practices that I recommend to address these issues. My book “Light on Law-Essential Information for Yoga Studios, Teachers and Wellness Businesses” has comprehensive information on these best practices.
1. Teachers should not ask students about pre-existing conditions at the beginning of class. Rather, teachers should make a general announcement that students should “keep themselves safe”, “honor their bodies” or similar language. Teachers should emphasize that students with injuries must exercise special care to protect themselves. When teachers offer modifications for poses, they should offer specific modifications rather than simply advising students to “modify.” Specific modifications should always be offered for those poses which tend to produce injuries. If a student has disclosed a specific condition, specific modifications should be provided.
2. Teachers who choose to ask students about pre-existing conditions may be subject to a higher duty of care. This may subject a teacher to a higher risk of liability if the teacher does not meet this higher duty of care. The higher duty of care may require a teacher to closely monitor a student with a condition and offer specific modifications to poses that could aggravate the student’s condition. If the teacher is not able to carry this higher duty of care, the best practice is that the teacher should not ask about pre-existing conditions.
3. Yoga therapists, specialty teachers and teachers providing private lessons have a duty to inquire as to any pre-existing conditions of their students.
4. If a teacher has actual knowledge of a student’s condition because it is open and obvious, the teacher has a duty to inquire about the condition. The teacher must then meet the higher duty of care with respect to caring for that student in class.
5. If a student volunteers information about a condition, the teacher has a duty to inquire about the condition. The teacher must then meet the higher duty of care with respect to caring for that student in class.
6. In most cases, studios and teachers should not obtain specific medical information about their students on new student questionnaires. However, this may be appropriate for yoga therapists and other teachers with specialty practices. If this information is collected, all of the privacy regulations, both state and federal, must be followed.
Confidential Treatment of Private Information
Yoga schools and teachers have an important obligation to maintain the confidentiality of all private information disclosed by students and clients.
Private information means any non-public information that a student or client designates as private or that, under the circumstances, should be treated as private. Private information includes a student or client’s personal contact and account information (i.e., name, address, credit card information, passwords, and email) medical and health information, and attendance records.
One common way that private information is disclosed is though gossip or third parties accidentally hearing private information being discussed. Yoga studios and teachers should be very mindful about discussing private information belonging to a student with anyone. These can be embarrassing to a student and in some cases personally or professionally damaging.
All yoga studios should maintain commercially reasonable policies and procedures to protect the confidentiality of all private information provided by its students and clients.
A school or teacher who receives any private information from a student or client should not disclose such information unless it obtains the written consent of the student or client. Generally, a school or teacher may disclose private information about a student or client without obtaining consent in the following situations:
(a) to comply with the law or the order of a court;
(b) to prevent bodily harm or danger to the student or client or to others; or (c) where the information has already been disclosed to the public.