Regulation of alternative medicine
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Because of the uncertain nature of various alternative therapies and the wide variety of claims different practitioners make, alternative medicine has been a source of vigorous debate, even over the definition of "
alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alt ...
". Dietary supplements, their ingredients, safety, and claims, are a continual source of controversy. In some cases, political issues, mainstream medicine and alternative medicine all collide, such as in cases where synthetic drugs are legal but the herbal sources of the same active chemical are banned. In other cases, controversy over mainstream medicine causes questions about the nature of a treatment, such as water fluoridation. Alternative medicine and mainstream medicine debates can also spill over into freedom of religion discussions, such as the right to decline lifesaving treatment for one's children because of religious beliefs. Government regulators continue to attempt to find a regulatory balance.
Jurisdiction Jurisdiction (from Latin 'law' + 'declaration') is the legal term for the legal authority granted to a legal entity to enact justice. In federations like the United States, areas of jurisdiction apply to local, state, and federal levels. Jur ...
differs concerning which branches of alternative medicine are legal, which are regulated, and which (if any) are provided by a government-controlled
health service Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profess ...
or reimbursed by a private health medical insurance company. The United Nations Committee on Economic, Social and Cultural Rights – article 34 (''Specific legal obligations'') of the General Comment No. 14 (2000) on ''The right to the highest attainable standard of health'' – states that Specific implementations of this article are left to member states. Two governments, acting under the laws of their respective countries, maintain websites for public information making a distinction between "alternative medicine" and "complementary medicine". In North America, the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
(NIH) (a part of the U.S. Department of Health and Human Services) states: :"...people often use the words “alternative” and “complementary” interchangeably, but the two terms refer to different concepts: 'Complementary' generally refers to using a non-mainstream approach together with conventional medicine. 'Alternative' refers to using a non-mainstream approach in place of conventional medicine. True alternative medicine is not common. Most people use non-mainstream approaches along with conventional treatments. And the boundaries between complementary and conventional medicine overlap and change with time. For example, guided imagery and massage, both once considered complementary or alternative, are used regularly in some hospitals to help with pain management

In the British Isles, the
National Health Service (England) The National Health Service (NHS) is the Publicly funded health care, publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare s ...
's NHS Choices (owned by the Department of Health) states: :"Although 'complementary and alternative' is often used as a single category, it can be useful to make a distinction between complementary and alternative medicine. This distinction is about two different ways of using these treatments". "Treatments are sometimes used to provide an experience that is pleasant in itself. This can include use alongside conventional treatments, to help a patient cope with a health condition. When used this way the treatment is not intended as an alternative to conventional treatment. The US
National Center for Complementary and Integrative Health The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), ...
(NCCIH) says that use of treatments in this way can be called 'complementary medicine'. Treatments are sometimes used instead of conventional medicine, with the intention of treating or curing a health condition. The NCCIH says that use of treatments in this way can be called 'alternative medicine'. There can be overlap between these two categories. For example, aromatherapy may sometimes be used as a complementary treatment, and in other circumstances is used as an alternative treatment. A number of complementary and alternative treatments are typically used with the intention of treating or curing a health condition. Examples include:
homeopathy Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths, believe that a substance that causes symptoms of a dis ...
,
acupuncture Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientifi ...
,
osteopathy Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Osteopathic manipulation is the core set of techniques in ...
,
chiropractic Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudosci ...
,
herbalism Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern reme ...



United States

In the United States the Food and Drug Administration (United States), Food and Drug Administration's online warnings for consumers about medication health fraud includes a section on Alternative Medicine Fraud, such as a warning that Ayurvedic products generally have not been approved by FDA before marketing.


Texas

In the state of Texas, physicians may be partially protected from charges of unprofessional conduct or failure to practice medicine in an acceptable manner, and thus from disciplinary action, when they prescribe alternative medicine in a complementary manner, if board specific practice requirements are satisfied and the therapies utilized do not present "a safety risk for the patient that is unreasonably greater than the conventional treatment for the patient's medical condition."


Colorado

Practice of alternative medicine in Colorado is governed by th
Colorado Natural Health Consumer Protection Act
The act prohibits techniques such as
psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
,
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
,
midwifery Midwifery is the health science and health profession that deals with pregnancy, childbirth, and the postpartum period (including care of the newborn), in addition to the sexual and reproductive health of women throughout their lives. In many cou ...
, or
dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions o ...
but, after full disclosure, permits many alternative practices such as
color Color (American English) or colour (British English) is the visual perceptual property deriving from the spectrum of light interacting with the photoreceptor cells of the eyes. Color categories and physical specifications of color are associ ...
or
aromatherapy Aromatherapy is based on the usage of aromatic materials including essential oils and other aroma compounds, with claims for improving psychological and physical well-being. It is offered as a complementary therapy or as a form of alternative m ...
which are deemed harmless. The exact provisions of the law are complex.


New Zealand

In New Zealand, alternative medicine products are classified as food products, so there are no regulations or safety standards in place.


Australia

In Australia, the topic is termed as ''complementary medicine'' and the
Therapeutic Goods Administration The Therapeutic Goods Administration (TGA) is the medicine and therapeutic regulatory agency of the Australian Government. As part of the Department of Health and Aged Care, the TGA regulates the quality, supply and advertising of medicines, pa ...
has issued various guidances and standards. Australian regulatory guidelines for complementary medicines (ARGCM) demands that the pesticides, fumigants, toxic metals, microbial toxins, radionuclides, and microbial contaminations present in ''herbal substances'' should be monitored, although the guidance does not request for the evidences of these traits. However, for the herbal substances in pharmacopoeial monographes, the detailed information should be supplied to relevant authorities The production of modern pharmaceuticals is strictly regulated to ensure that medicines contain a standardized quantity of active ingredients and are free from contamination. Alternative medicine products are not subject to the same governmental quality control standards, and consistency between doses can vary. This leads to uncertainty in the chemical content and biological activity of individual doses. This lack of oversight means that alternative health products are vulnerable to adulteration and contamination. This problem is magnified by international commerce, since different countries have different types and degrees of regulation. This can make it difficult for consumers to properly evaluate the risks and qualities of given products.


Denmark

In Denmark, herbal and dietary supplements is the designation of a range of products, which have in common their status as medicine belonging under the Danish Medicines Act. In the Danish Medicines Act there exist four types of herbal and dietary supplements: Herbal medicinal products, Strong vitamin and mineral preparations, Traditional botanical medicinal products and Homeopathic medicinal products. Some dietary supplements fall within a special category of products, which differ from the above in that they are not authorized medicinal products. Dietary supplements are regulated under the Food Act and are registered by the Danish Veterinary and Food Administration.


Alternative therapists

Denmark has a registration system for alternative therapy practitioners, RAB.Registration of Alternative Practitioners – RABKnowledge and Research Center for Alternative Medicines homepage
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Switzerland

The
Swiss Federal Constitution The Federal Constitution of the Swiss Confederation (SR 10; german: Bundesverfassung der Schweizerischen Eidgenossenschaft (BV); french: Constitution fédérale de la Confédération suisse (Cst.); it, Costituzione federale della Confederaz ...
prescribes that the Confederation and the Cantons shall, within the scope of their powers, ensure that consideration is given to complementary medicine.


United Kingdom

Safety, quality and
efficacy Efficacy is the ability to perform a task to a satisfactory or expected degree. The word comes from the same roots as ''effectiveness'', and it has often been used synonymously, although in pharmacology a pragmatic clinical trial#Efficacy versu ...
are the only criteria on which United Kingdom legislation is founded to control human medicines. Regulation of medicines and medical devices, to ensure they work and are acceptably safe, is the responsibility of the
Medicines and Healthcare products Regulatory Agency The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department of Health and Social Care in the United Kingdom which is responsible for ensuring that medicines and medical devices work and are acceptably ...
. The legal status of medicines is determined under the
Medicines Act 1968 The Medicines Act 1968 is an Act of Parliament of the United Kingdom, more properly: An Act to make new provision with respect to medicinal products and related matters, and for purposes connected therewith. It governs the control of medicines for ...
and European Council
Directive 2001/83/EC Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the Community code relates to medicinal products for human use in mainly countries that are part of the European Union. The Directive dealt with the disparitie ...
which control the sale and supply of medicines. The legal status of medicinal products is part of the marketing authorisation which allows products to be available on a prescription (referred to as
Prescription Only Medicines A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The rea ...
), or in a pharmacy without prescription under the supervision of a
pharmacist A pharmacist, also known as a chemist (Commonwealth English) or a druggist (North American and, archaically, Commonwealth English), is a healthcare professional who prepares, controls and distributes medicines and provides advice and instructi ...
, or on general sale and saleable in general retail outlets without the supervision of a pharmacist. There are 12 organisations in the United Kingdom known as health and social care regulators. Each organisation oversees one or more of the health and social care professions by regulating individual professionals across the UK.GMC: UK Health and Social Care Regulators
/ref> The
General Medical Council The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...
is one of these, for medical practitioners who as
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s are registered and licensed to practise under the
Medical Act 1983 The Medical Act 1983 (c 54) is an Act of the Parliament of the United Kingdom which governs the regulation and credentials of the medical profession, and defines offences in respect of false claims of fitness to practise medicine. Detail The act ...
. Councils for other practitioners include the
General Chiropractic Council The General Chiropractic Council (GCC) is an independent statutory body established by Parliament to regulate the chiropractic profession in the United Kingdom. It protects the health and safety of the public by ensuring high standards of practic ...
under the Chiropractors Act 1994 and the
General Osteopathic Council The General Osteopathic Council (GOsC) is the regulator of the practice of osteopathy in the United Kingdom. The GOsC was established in 1997 following the Osteopaths Act 1993 to 'provide for the regulation of the profession of osteopathy' with t ...
under the
Osteopaths Act 1993 The Osteopaths Act 1993 (c. 21) is an Act of the Parliament of the United Kingdom to regulate the practice of osteopathy. It received Royal Assent on 1 July 1993. The Act created the General Osteopathic Council The General Osteopathic Council ...
.


See also

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Regulation and prevalence of homeopathy Homeopathy is fairly common in some countries while being uncommon in others. In some countries, there are no specific legal regulations concerning the use of homeopathy, while in others, licenses or degrees in conventional medicine from accred ...


References

{{reflist *
Alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alt ...