Is it ethical for nurses to perform Reiki on their patients?

While there is nothing unethical about using Reiki, it is important for nurses and other healthcare practitioners to follow a few basic rules to make sure that their conduct is ethical and appropriate.

Helping others is at the core of the nursing profession, and I am sure that every nurse who has ever done Reiki for a patient has only done it with the patient’s best interests at heart.

As someone who has seen first-hand the incredible positive effects that Reiki may have on people with various health conditions (scientific research to back this up is still lagging), I can tell you that for many nurses who know Reiki, it may feel unethical not to offer it. How could you not offer a patient something that has no side effects and that the nurse knows could potentially help the patient tremendously?

Because of this, many caring nurses who practice Reiki and other holistic modalities may accidentally cross some ethical and professional lines while trying to help their patients.

Here are a few basic rules that may help avoid some of these ethical dilemmas:

• BE FAMILIAR WITH REIKI LAW Reiki is a beautiful, gentle healing art, but we don’t want to get into trouble or find ourselves in an ethical conundrum doing it. Each Reiki practitioner, whether or not he or she works in a healthcare setting, should be familiar with federal, state, and local laws that regulate the practice of Reiki. Unfortunately, Reiki laws in many places are very restrictive and/or contradictory. Until this changes, not only offering it to patients may be illegal in some areas, but it may also be unethical to perform Reiki without following specific rules outlined by the law. Giving Reiki ‘illegally’ would certainly go against professional nursing conduct. Learning what you can and cannot do with Reiki according to the law is each nurse's professional responsibility.

• KNOW THE COMPANY POLICY REGARDING REIKI The nurse should confirm with management at her workplace ahead of time that doing Reiki for patients does not violate any company policies. Since Reiki (regardless of how amazing it is) is not a standard part of nursing care, it may be against the company policy to perform a ‘non-nursing’ activity including Reiki during working hours (especially while patients nursing needs have not been met). Giving Reiki while neglecting nursing obligations is unprofessional and can be considered unethical as well. If the nurse’s workplace does not allow Reiki, the nurse can advocate for a change in the company policy, as opposed to doing Reiki secretly. That would be the appropriate course of action. Also, on a side note, performing non-nursing tasks (including Reiki) for patients may cause boundary excursions and violations in some cases, and so it is important for nurses to be mindful of that possibility as well.

• AVOID SELF REFERRAL Potential boundary violations may also arise when Reiki is offered to patients outside of the working hours, on nurses’ own time. In general, it may be unethical for a nurse to offer her patients to come for paid Reiki (or other) services. There are circumstances, where it may be unavoidable (like in really tiny communities), but for the most part, I would advise against self-referral because of the potential conflict of interest. Offering free Reiki to patients during nurse’s time off is not necessarily unethical, but it pushes professional boundaries, so extra mindfulness regarding this would be a good idea.

• GIVE INFORMATION ABOUT REIKI FROM A MEDICAL PERSPECTIVE It is important that the patient is given information about Reiki, and that it is stated that Reiki is not a scientific/medical concept and that while many patients who receive Reiki have had amazing results, Reiki does not diagnose or treat any medical condition or ailment. As healthcare practitioners, we do not want to mislead our patients into believing that Reiki will “heal” or “cure” them or that it has been proven by science (a lot more research is still needed to prove it, and we should not jump ahead of ourselves, regardless of our personal experiences with Reiki). Being in a medical setting, we have a professional obligation to share information from a medical perspective. We can always share our experiences with Reiki, but they should be qualified as our experiences as opposed to medical or scientific facts. The patients themselves can find plenty of information online about the benefits of Reiki as described by non-medical professionals. They can also choose to experience those benefits for themselves.

• GET CONSENT The nurse should always get consent from each patient (or patient representative, when appropriate) before doing Reiki. It would be unethical to perform Reiki (or do anything else for that matter) against the patient’s will. Depending on the organization where you work, that consent may be a part of other consent forms signed by the patient ahead of time, but it would be the nurse’s responsibility to know this, as well as to confirm with the patient that they open to Reiki (patients should have the right to refuse it). On a side note, many organizations may not take all the details of Reiki law into consideration when creating their standard forms and may not follow proper consent procedures for Reiki. That brings us back to point #1 - it would be the nurse's responsibility to know what the laws are and whether there are any specific Reiki consents that are mandated by those laws.

• ASK FOR PERMISSION TO TOUCH (IF DONE) Since many Reiki styles involve touch, it’s important to check with each patient if there are any areas of the body that they do not want to be touched and to follow the patient’s wishes in that regard.

• MAKE SURE THAT ALL YOUR REIKI TECHNIQUES ARE APPROPRIATE FOR EACH PATIENT There are many Reiki styles and numerous Reiki techniques. Some involve touch, others may involve massage-like motion, some may have the patient lying in a specific position, etc., etc., etc. It would be unethical to follow your Reiki style’s procedure exactly if the patient is unable to tolerate it. For example, if the patient is unable to lie face down, he or she should not be ‘forced’ to do it even if it is a part of the ‘regular’ Reiki ’routine’ that the nurse is used to. It would be unethical to use a Reiki technique that’s not appropriate for a specific patient.

• BENEFITS SHOULD OUTWEIGH THE RISKS As the previous example indicates, nurses should be mindful of the appropriateness of the Reiki techniques they use for each patient. Although there are no circumstances that I can think of where Reiki itself would not be of benefit (at least in my experience), it is always important to approach Reiki from the perspective of potential benefits vs. potential harm. The main ethical question/challenge I foresee in this category would be not doing Reiki when it could be of benefit. For example, if a patient is open to Reiki, Reiki is allowed by law, the nurse knows that Reiki could relieve this patient’s suffering (benefit), the nurse knows that not doing Reiki would result in ongoing suffering (harm) - should the nurse do it even if it is against the company policy? I would recommend working on changing the policy and working with your organization’s ethics committee.

• PATIENT VS. FAMILY If a clear-minded patient wants Reiki and you are allowed to do it by law and by your company, but the family refuses it, the ethical thing to do would be to follow the patient’s wishes. The opposite is also true - if a clear-minded patient does not want Reiki, but the family requests it, you should follow the patient’s wishes. In the same scenarios except for the patient being confused/unable to make decisions, follow the advance directives and/or family wishes (one may supersede the other depending on where you are practicing nursing).
  

​

• REIKI ABILITY CANNOT BE ‘TURNED OFF’ The final and perhaps the most peculiar ethical aspect of Reiki in nursing relates to the fact that it is impossible to ‘turn off’ one’s Reiki ability. So anyone who comes in contact with a nurse who has had proper Reiki training will naturally receive Reiki during the nurse-patient interaction - any touch from the ‘Reiki nurse’ (and even proximity) will result in the patient getting some Reiki without the patient or the nurse even thinking about it. I’ve mentioned earlier that it is important for a nurse to get consent from each patient before giving Reiki, by that I mean that if a nurse offers a complete full-on Reiki session to a patient she must obtain proper consent. However, there is no way to get consent for Reiki every moment of a normal nurse-patient contact. Reiki will be given naturally in those moments - there is no way to prevent it - and I do not see any way to consent or not consent to it during normal patient care. Of course, there is absolutely no harm in getting Reiki. So patients should not be worried about inadvertently being harmed by Reiki if their nurses happen to know it. That’s not how it works.

There could be many other types of ethical scenarios of Reiki in nursing, but it is impossible to predict all of them. Some ethical questions and dilemmas are easy to answer and resolve, while others may be more challenging. Each situation is unique and must be addressed in a unique way while staying true to the fundamentals of professional and ethical behavior.

The bullet points above are a few basic ethical suggestions regarding using Reiki in nursing practice and they closely relate to the general principles of nursing ethics, which are justice, beneficence, nonmaleficence, accountability, fidelity, autonomy, and veracity. You can read more about these pillars of nursing ethics HERE.

Hope this helps bring clarity to the ethics of using Reiki in a nursing profession.