INHE 3004 Week 5 Case Analysis Example

A Massage Therapist Tells a Client to Halve Her Blood Pressure Pill: A Case Analysis From Facts to Issue, Rule, Application and Conclusion, With the Ethical Question Treated Separately

Student Name

Walden University

INHE 3004: Legal and Ethical Issues in Integrative Health Care

Instructor Name

Month Day, Year

A Massage Therapist Tells a Client to Halve Her Blood Pressure Pill: A Case Analysis From Facts to Issue, Rule, Application and Conclusion, With the Ethical Question Treated Separately

Facts

Kim, a massage therapist certified by the California Massage Therapy Council, has treated a 58-year-old client for neck tension monthly for a year. At one session the client mentions feeling lightheaded when she stands up and says she takes a prescription drug for high blood pressure. Kim tells her to cut the pill in half until the dizziness passes and to start a magnesium supplement, which Kim sells, to "keep her pressure steady." The client follows the advice. Two weeks later her blood pressure at a pharmacy kiosk reads 172/104. The facts are stipulated for this analysis.

Issue

Did Kim act outside the scope of her credential and outside the protection California extends to unlicensed health practitioners, by advising a client to reduce a prescribed medication and start a supplement for blood pressure?

Rule

Two rules govern. First, California defines massage, for purposes of the certification Kim holds, as the scientific manipulation of the soft tissues (California Legislative Information, 2026b). Certification under that chapter therefore covers massage, not advice about medications. Second, the state's health freedom law shields unlicensed practitioners from prosecution for practicing medicine without a license only if they give required disclosures and do none of a list of prohibited acts. Two of those acts matter here: advising a client to stop a prescribed drug, and knowingly diagnosing and treating a condition where doing so puts the client at risk of grave injury, serious illness or death (California Legislative Information, 2026a).

Application

Kim's advice was not massage. Telling a client to change a prescription dose and to take a supplement for blood pressure has nothing to do with manipulating soft tissue, so her certification gives it no cover. The question then becomes whether the health freedom law protects it.

The prohibition on recommending discontinuance is the closest match, but Kim told the client to halve the dose, not stop it. A narrow reading might say halving is not discontinuing. The fifth prohibition is a better fit. Kim interpreted the client's dizziness as a reason to lower a blood pressure medication, which is diagnosing and treating, and she did so in circumstances that created a real risk of serious harm: uncontrolled blood pressure can lead to stroke or heart attack, and the client's later reading of 172/104 shows the risk was not hypothetical. On this reading, Kim lost the law's protection, and her advice could be treated as the unlicensed practice of medicine. Her sale of the supplement she recommended adds a conflict of interest but does not change the legal analysis.

Conclusion

Kim acted outside the scope of her massage certification, and her advice likely removed the protection of California's health freedom law because it involved diagnosing and treating a condition in a way that created a risk of serious harm. Whether a prosecutor would pursue it is a separate question; the analysis concerns whether the line was crossed, and it was.

The Separate Ethical Question

Even if no law applied, the advice would be ethically wrong. The duty to avoid harm rules out gambling with a client's health in areas beyond one's training, and respect for the client's autonomy requires that her choices about medication be informed by someone who understands the drug (Beauchamp & Childress, 2019). The right response to the client's dizziness was to suggest she contact her prescriber promptly, since lightheadedness on standing can itself be a side effect worth reporting. The ethical failure would remain even under a reading of the law that excused Kim.

References

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

California Legislative Information. (2026a). Business and Professions Code section 2053.5. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC&sectionNum=2053.5

California Legislative Information. (2026b). Business and Professions Code section 4601. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC&sectionNum=4601