The Law Proposal on Non-Conventional Medicine – a “ChiroPatient” Opinion

"But will patients really be cared for?"

We have studied the proposal for a law on recognition of non-conventional practices and, from a reading of the first article, the indications would appear to be good.

The legislator, in the name of the Italian Republic and with respect to the Constitution, affirms:

• recognition of the principle of scientific pluralism;
• recognition of the right to use medicines and non-conventional practices for the advancement of science;
• recognition of the patient’s freedom of choice of treatment.

Wih respect to these affirmations, it declares:

• ... in the interests of protecting patients’ health, it guarantees and favours appropriate professional qualification of health workers in medical and non-conventional practices;
• ... recognizes the need for harmonization of the fundamental principles established by the regulations of Member Countries of the European Union with regard to recognition of medical and non-conventional practices, university training and the regulation of professional activity.

Under the proposed law, eight specialist fields are reserved for those with degrees in medicine, dentistry and veterinary science, two for those with degrees in chiropractic or osteopathy, and four for health workers who are not doctors.

All non-conventional medicine will, however, be “governed” by a Permanent Committee of a bureaucratic/medical nature which, in spite of appearances of pluralism and democracy, gives the impression of a kind of dividing up of these disciplines. In addition, all non-conventional activities will have their own specific Committees!

It is expected that these Committees will include delegates of scientific associations representing each of the non-conventional health professions. These scientific societies or associations will be accredited by the Ministry of Health on the basis of unspecified requirements.

We will not discuss the eight specialist fields reserved for those with degrees in medicine, dentistry and veterinary science, but we consider it essential to put one question:

 What will be the limitations on those with degrees in dentistry and veterinary science regarding the practice of non-conventional medicine? We hope that the veterinarians will be able to apply their skills solely on animals and that dentists will be able to use them solely on the dental apparatus. It turns out that there are in fact specific laws that place limits on interventions by graduates in these two disciplines. The proposed law groups these three categories together and does not clarify the limitations placed on dentists and veterinarians. Perhaps the patient who chooses homeopathic treatment will be able to turn to a doctor, dentist or veterinarian without distinction?

In making a more detailed analysis of the articles regarding chiropractic, our first impression is that we are facing the usual Italian-style mix up which tries to please everyone at the risk of missing out the professional requirements for treating and guaranteeing our health.

 For chiropractic, the price of independence will be:

• “government” of the profession by the Committees and sub-committees, whose requirements are extremely vague;
• a general amnesty that accepts anybody who up to now has demonstrated merely an intention to practise chiropractic.

The Committees: In addition to the Permanent Committee for all medical and non-conventional practices, for chiropractic and osteopathy two committees are envisaged – one for professional training and one for the recognition of academic qualifications.

 Even on these committees, members of accredited scientific associations will be present. What will the requirements be for recognition as a scientific association in chiropractic?

 To date, chiropractic in Italy has not been considered a profession. In European and other countries round the world where it is recognized, it enjoys full independence from medicine. Governing bodies exist (the Council on Chiropractic Education and the European Council on Chiropractic Education) to regulate the profession by setting training standards at the European and global levels. Recognition as a Doctor of Chiropractic is accorded only to those who have taken a degree at one of the colleges recognized and accredited by these authorities as having maintained the required standards of education. 

 The only association recognized in Italy by the European and worldwide authorities is the Italian Association of Chiropractors (l’Associazione Italiana Chiropratici).

 Other associations, whose members style themselves chiropractors, are not recognized by European or world chiropractic authorities.

In the same way, “Advanced Training Courses in Osteopathy and Chiropractic” set up by dentists at the University of Rome La Sapienza, or the “Course in Chiropractic, Osteopathy and Naturopathy” which runs at the Trapani ASL do not respect the teaching requirements imposed by international authorities and have no Doctor of Chiropractic among the teachers.

 Furthermore, it is envisaged that these Committees will include two university lecturers: but how will the university lecturers be chosen to determine the form of a degree course that does not yet exist? And again: if no degree course in chiropractic exists, which university lecturers can be members of the committee for the recognition of academic qualifications obtained abroad?

The Amnesty: It is with respect to the recognition of academic qualifications that we note, however, the most dangerous point for those who practice the profession seriously, and above all for us, the patients. Regarding the recognition of academic qualifications, we read that the Committee: recognizes the qualifications already obtained, and in the absence of such qualifications takes account of professional activity carried out for at least five years.  

According to this clause, anyone who is not in possession of a degree in chiropractic but who has practised the profession illegally for at least five years will be rewarded, being thus recognized as a fully qualified chiropractor! And further, a person who has never practised the profession of chiropractic but who can find a reasonable number of people to declare that they have been treated by him over at least five years will be rewarded, being thus recognized as a fully qualified chiropractor! A person possessing a degree in medicine or dentistry or (in Trapani) a diploma as a podiatrist, beautician etc. having followed one of these courses, will be rewarded, being thus recognized as a fully qualified chiropractor! A person possessing a degree from a University that exists only on paper but is not recognized by the Italian government nor accredited by official international bodies will be rewarded, being thus recognized as a fully qualified chiropractor!

The 300 chiropractors (with regular degrees from the colleges accredited in Europe and worldwide) currently practising in Italy will, when the new law comes into force, become as if by magic at least 30,000.

But how will we, the patients, be able to distinguish the real chiropractors?

What will be the effects on our health?

 What will the consequences be for the profession and for those who practise it honestly?