Law and Ethics in Complementary Medicine

A handbook for practitioners in Australia and New Zealand

Michael Weir

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000257700
• Edition: 5
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

'A valuable resource for those in clinical practice and students undertaking primary and secondary qualifications in the complementary medicine and therapy disciplines.' Caroline Smith, Professor, Complementary Medicine Research, National Institute of Complementary Medicine, Western Sydney UniversityComprehensive, unique and reflective of the current Australian legislative framework and AHPRA regulations, Michael Weir's Law and Ethics in Complementary Medicine remains the most widely used reference text in the field. A valuable handbook for professionals, students and researchers, the text addresses legal and ethical issues across a broad range of traditional, complementary and integrative practices.The text deals with legal and ethical issues in clinical relationships and provides practical guidelines for setting up and running a professional practice. Michael Weir systematically outlines the various aspects of the law which impact on clinical practice, including legal obligations to clients, consumer legislation and complaints processes, and professional boundaries. He explains how to navigate professional indemnity insurance, and the steps you need to take in setting up a professional practice from establishing a business name to dealing with employees. He also outlines the role of codes of ethics, and explores how to deal with tricky ethical issues in daily practice.This fifth edition is fully updated with in-depth treatment of the issue of ethical practice and professional decision making. It addresses recent changes in regulation and case law, including the development of the National Code of Conduct for Healthcare Workers and also now includes yoga and holistic counselling as modalities of complementary medicine.

1
Introduction

Successful professional practice requires technical, business and personal skills, as well as an ability to deal with a rapidly changing profession, society and economy. An understanding of where your modality fits into the health sector can help with these challenging requirements. This chapter offers a short overview of what complementary medicine is and how it is regulated.

The Ten Commandments of Professional Practice at the end of this chapter summarise the most important themes of the book. By understanding and integrating these principles into day-to-day practice, a health practitioner will not only earn the respect of clients and colleagues, but will create a more successful and enjoyable practice.

Action plan

• Investigate and appreciate your role and that of your modality in complementary medicine.
• Read and understand the Ten Commandments of Professional Practice.
• Understand that you are a professional.

What is complementary medicine?

Looking at different ways to approach the healing process can clarify how a practitioner fits into the healthcare industry and how he or she relates to other health professionals.

Terminology

Complementary medicine is that part of the health sector that relies primarily upon holistic, homoeopathic, traditional or natural therapies rather than an allopathic approach to medicine, which characterises Western or orthodox medicine.

This book is useful for all complementary medicine practitioners but will deal specifically with:

• acupuncture
• chiropractic
• herbal medicine
• homoeopathy
• holistic counselling
• naturopathy
• osteopathy
• therapeutic massage
• traditional Chinese medicine
• yoga

In this book, we focus on a broad spectrum of modalities, and it is necessary to refer to all of them. It can be difficult to find a term that adequately covers all modalities, techniques or systems because they often exhibit contrasting philosophies and approaches, so in this book we have chosen to use the term ‘complementary medicine’. This appears to provoke the least philosophical objection for the majority of modalities. Some may bridle at the suggestion that their modality is complementary to anything. Some will perceive their modality as all-encompassing and complete in itself. Others will be relaxed with this terminology. The focus of the book is not upon the provision of complementary medicine by orthodox medicine practitioners, though most of the book will provide insights for these integrative practitioners.

The term ‘natural therapies’ is accepted by some and understood by many laypeople, but some therapies are not particularly natural. The term ‘alternative medicine’ was considered, but this may differentiate it unnecessarily from orthodox medicine. Many modalities have grown out of traditional medicine, so some reference to traditional medicine may be suggested. These modalities may have little in common with newer modalities. The terms ‘complementary and alternative medicine’ (CAM) or ‘traditional, complementary and integrative medicine’ (TCIM) are in common parlance, but they are somewhat clumsy to use in the title and throughout the book.

The term ‘complementary medicine’ therefore has been chosen as a useful and inclusive description of the modalities discussed in this book. The use of this term is not intended to exclude or sideline any particular approach or philosophy in order to limit the role played by complementary medicine or its potential as an alternative therapy in the health sector.

Approaches to healing

The various philosophies and approaches to treatment used in complementary medicine are hard to categorise, but a helpful starting point is to compare allopathic and homoeopathic approaches. Orthodox medicine is based on an allopathic approach to healing. The practitioner introduces into the body substances (such as pharmaceutical products) designed to counteract the effect of symptoms of disease or injury, and may use invasive procedures such as surgery. An allopath generally regards the human body as a machine made of many parts, and the doctor as an expert who ‘fixes the body’. An allopath will seek to fix the diseased or injured part without necessarily focusing on the body as a whole.

In contrast, a homoeopath’s aim is not to counteract disease but rather to stimulate a healing response. Homoeopathy is based on the principles of similars—that is, a homoeopath introduces into the body tiny amounts of a substance to produce an effect similar to the disease symptoms, aiming to stimulate the healing response. Other modalities share a ‘holistic’ approach to healing that perceives the body as a whole system. Rather than focusing on the disease state itself, the practitioner assesses how imbalance in the body may be contributing to ill-health. The task of the practitioner is to restore balance and equilibrium to the body.

Complementary medicine practitioners may on occasion use a symptomatic approach influenced by allopathy. A practitioner may apply different modalities such as kinesiology, acupuncture, therapeutic massage and naturopathy, each of them different in approach but directed towards the goal of bringing harmony and balance to the body. The less authoritarian therapeutic relationship preferred by complementary medicine practitioners, involving more a health partnership between practitioner and client, is reflected in the use of the term ‘client’ in this book, as distinct from the term ‘patient’.

Categories of complementary medicine

One way to understand how the various modalities of complementary medicine relate to each other is to divide them into four general types:¹

1. Complete systems of healing such as acupuncture, traditional Chinese medicine, herbal medicine, osteopathy, chiropractic, homoeopathy and naturopathy. These disciplines seek to provide complete explanations of the cause of disease, though most practitioners do acknowledge the boundaries of the discipline and the role to be played by orthodox medicine. This book will explore in some detail where these boundaries should be drawn for the benefit of clients and practitioners.
2. Diagnostic methods such as iridology, kinesiology and aura analysis. Some practitioners may rely heavily on these methods, while practitioners of complete healing systems will often use them to detect disease, abnormality or imbalance. For example, a chiropractor may use kinesiology to help diagnose a misaligned spine or a naturopath may use iridology to diagnose imbalances in the body or organs.
3. Therapeutic modalities such as musculoskeletal therapy, therapeutic massage, reflexology, aromatherapy, spiritual healing, holistic counselling and shiatsu. These modalities emphasise therapeutic effect rather than diagnosis. For example, a practitioner of therapeutic massage may aim to heighten the recipient’s sense of well-being rather than to alleviate any particular diagnosed illness, though that might be the result of the treatment. In some cases, such as in therapeutic massage and musculoskeletal therapy, the focus of the treatment may be on dealing with a specific injury or pain.
4. Self-help measures such as relaxation, yoga, qi dong, tai chi, meditation, guided visualisation or fasting.

Regulation of health professionals

Regulation of health professionals defines appropriate roles for complementary medicine practitioners in the healthcare sector.

Models of regulation

Regulators tend to focus on the role of complete systems of healing because they provide a greater risk of harm. For example, traditional Chinese medicine involves the ingestion of herbs, acupuncture involves the piercing of the skin and chiropractic involves manipulation of the spine, which may involve an element of risk.

Orthodox medicine has had a profound effect on the regulation of complementary medicine. In the United Kingdom, orthodox medicine rose to pre-eminence over other traditional forms of healing during the course of the fifteenth century. The process culminated in the Medical Act 1858 (UK), which gave state endorsement and protection for orthodox medicine.² This history has to a great extent been mirrored in Australia.

Medical practitioners and other allied health professionals—such as physiotherapists, optometrists and podiatrists—work within subsets of medical practice as primary health practitioners, and are recognised by state legislation based upon a national health practitioner legislative scheme discussed in Chapter 3.

Osteopaths, chiropractors and practitioners of traditional Chinese medicine, acupuncturists and Chinese medicine dispensers are also registered health practitioners in Australia. All other complementary medicine practitioners are unregistered health professionals. The unregistered complementary medicine practitioners—for example, therapeutic massage therapists, homoeo-paths, naturopaths and herbal medicine practitioners—need to be aware of a few statutorily defined restricted acts that only specified registered health ...

Table of contents

• Cover
• Half Title
• Dedication Page
• Title Page
• Copyright Page
• Contents
• Preface to the 5th edition
• 1 Introduction
• 2 Ethical practice and professional decision-making
• 3 Restricted acts and protected titles
• 4 Negligence and professional responsibilities
• 5 Goods and consumer issues
• 6 Modalities
• 7 Setting up a practice
• 8 The legal process
• Notes
• Table of cases
• Table of legislation
• Index