Christine is a sedentary 52-year-old woman with prediabetes and a body mass index of 34 kg/m2. Her personal physician has provided a medical clearance, with no restrictions for exercise. Christine is an avid fan of the Biggest Loser television program and has read about high-intensity interval training online and in several women’s magazines; she is convinced that this is the answer to losing weight and improving her health. She is interested in purchasing a large personal training package from you only if you put her on a high-intensity program and act as a boot camp instructor to help motivate her. You suspect that a high-intensity program is not appropriate for Christine, but you really need some new clients because business has been slow lately. Will you take her as a client? After all, Christine’s doctor cleared her for exercise, and you will monitor her closely. Or will you refuse to take Christine as a client with the requirement that you put her on a high-intensity program?
Exercise professionals are faced regularly with ethical issues and must make decisions about the best way to handle situations that can sometimes be difficult. Many professional organizations have a code of ethics to guide members of the profession in making these difficult decisions. Professionals are expected to adhere to the code of ethics to preserve the integrity of the profession and to prevent exploitation of the client or patient. Maintaining the integrity of the profession not only benefits the client but also other individuals who are part of that profession.
A “code of ethics” is defined as a guide of principles designed to help professionals conduct business honestly and with integrity. A code of ethics document may outline the mission and values of the organization, how professionals are supposed to approach problems, the ethical principles based on the organization’s core values and the standards to which the professional will be held (5).
The American College of Sports Medicine (ACSM) Code of Ethics for certified and registered professionals is intended to help all certified and registered ACSM Credentialed Professionals (ACSMCP) establish and maintain a high level of ethical conduct, as defined by standards by which an ACSMCP may determine the appropriateness of his or her conduct (Table). The code applies to all ACMCPs, regardless of ACSM membership status (applies to both members and nonmembers). The principles and standards outlined in the Code of Ethics are general statements expressing the ethical and professional ideals certificants and registrants are expected to display in their professional activities and can help guide the decisions of the exercise professional.
Scope of practice and confidentiality are two areas that can present ethical dilemmas for the exercise professional. Scope of practice is the range of responsibility that determines the boundaries within which a profession operates and defines what tasks a professional can do, with whom the professional can work, what settings are appropriate, and what type of oversight is necessary (4,6). Each ACSM certification has its own unique scope of practice that is further delineated as job tasks and finally as knowledge and skill statements. Certified professionals are expected to adhere to the job tasks and skills outlined by ACSM to be considered operating within the boundaries of their certification. It is challenging when clients ask exercise professionals to go beyond their scope of practice. For example, clients may ask for advice on nutritional supplements or ask to be put on a diet. They might complain about shoulder pain and ask you what you think is wrong with it. In these cases, it usually is more appropriate to refer the client to the appropriate professional such as a registered dietician or a physician rather than to go beyond one’s scope of practice.
Exercise professionals have a great deal of access to private information, most often associated with a patient’s medical history. However, clients and patients often share many other elements about their lives with exercise professionals, even when that information is not solicited. Although it can be tempting to discuss something with a colleague or tell a story to friends or family members, exercise professionals have the ethical responsibility to maintain confidentiality at all times.
Individuals in supervisory roles often are faced with difficult situations that affect employees or members of their facility. Abiding by the ACSM Code of Ethics also can help guide these decisions. Consider the following situation. Samantha Smith, B.S., ACSM-HFS, fitness director at a corporate fitness center, needs to replace a group exercise instructor who is leaving the company. The vice president of the company regularly works out in the fitness center and knows that a new instructor needs to be hired within the next 2 weeks. He casually mentions that his girlfriend likes to take exercise classes and, the next day, his girlfriend applies for the job. She has been taking Zumba classes for about a year but has never taught any type of class and is not certified. Although Samantha knows that this job candidate is not qualified, she feels pressure to hire her because she is the vice president’s girlfriend. The scope of practice and performance domains for the ACSM-HFS certification identify management as an essential responsibility. An examination of the job tasks with associated knowledge and skill statements can help Samantha justify her decision that a more qualified individual is needed to teach safe and effective group exercise classes. Specifically, the job task states that the HFS “establishes policies and procedures for the management of health fitness facilities based on accepted safety and legal guidelines, standards, and regulations” (3).
In the previous example, it was a conflict of interest for the vice president to suggest his girlfriend be hired for a position within the company he worked for,but conflicts of interest commonly occur. The ACSM Ethical and Professional Conduct Committee has defined a conflict of interest as “a significant financial interest in a business or other direct or indirect personal gain or consideration provided by a business that may compromise or have the appearance of compromising an ACSM member’s professional judgment (2). Company X might offer to provide a fitness director with $500 worth of free fitness apparel in exchange for requiring the group exercise instructors to wear Company X clothing when teaching class. Is this a conflict of interest?
Most conflict of interest statements include disciplinary statements that allow the profession to define a standard of conduct and ensure that individual practitioners meet this standard. If an individual does not act according to the standard of conduct, he or she can be disciplined by the professional organization. This allows professionals who abide by the acceptable standard of conduct to practice with the knowledge that they will not be undermined by individuals who have questionable professional ethics. It also helps to maintain public trust in the profession. For example, the profession suffers when there is a news item about an individual who was injured by a personal trainer who was not certified, certified by an organization that is not credible, or performs duties that are outside of his or her scope of practice.
The ACSM discipline policy is: “Any ACSMCP may be disciplined or lose his or her certification or registry status for conduct which, in the opinion of the Executive Committee of the ACSM Committee on Certification and Registry Boards (CCRB), goes against the principles set forth in this Code. Such cases will be reviewed by the ACSM CCRB Ethics Subcommittee, which may include a liaison from the ACSM Committee on Ethics and Professional Conduct, as needed, based on the ACSM membership status of the ACSMCP. The ACSM Ethics Subcommittee will make an action recommendation to the ACSM CCRB Board’s Executive Council for final review and approval” (1).
In addition to ACSM’s Code of Ethics for certified and registered professionals, there also is a Code of Ethics for members of ACSM (http://www.acsm.org/join-acsm/membership-resources/code-of-ethics). This code of ethics also may help you make decisions about the health and safety of your clients and patients and protect against members or professionals who are deficient in ethical conduct.
2. American College of Sports Medicine. Leadership Manual 2012–2013. Indianapolis (IN): American College of Sports Medicine; 2012. p. 8.
3. Costanzo D. American College of Sports Medicine certifications. In: Pescatello L, editor. ACSM’s Guidelines for Exercise Testing and Prescription. Baltimore (MD): Lippincott, Williams & Wilkins; 2014: 419–437.
4. Fitts T, Lite R. Professional behaviors and ethics. In: Liguori G, editor. ACSM’s Resources for the Health Fitness Specialist. Baltimore (MD): Lippincott, Williams & Wilkins; 2014. p. 352–370.