• CAM-summaries
• CAM systematic reviews
• CAM and the law
  • Introduction
    • Preface
    • Report summary
    • Use of CAM
    • Why regulate?
    • Recommendations by WHO and EU
    • Relation to earlier publications
    • Methods and materials
  • Legal overview
  • Regulation of medical practise
  • Regulation of herbal products
  • Legal regulation
• Prevalence of CAM use

Relation to earlier publications

In 1985 Stephan (ref 1) categorised different legislative approaches to regulate medical practise. He distinguished four systems; the monopolistic system, the tolerant system, the inclusive system and the integrated system. In Europe, only the monopolistic and tolerant systems are represented according to his categorization. In the monopolistic system only the practise of "scientific" medicine by authorised professionals is recognised as legal to the exclusion of, and sanctions against, all other forms of care. In the tolerant system only the practise of scientific medicine is regulated, while the practise of various forms of CAM is to some extent tolerated by law. These two systems can, however, overlap. In 1997 De Bijl and Nederveen-Van de Kragt (ref 2) introduced a new category called the mixed system. In this system only health care professionals are allowed to perform specific medical procedures and treat some serious diseases, and the violation of this limited monopoly results in an offence. For the remaining medical practises, there are no such restrictions.

In his book, "The Legal Status of Complementary and Alternative Medicine in Europe" (1999), Stefano Maddalena concludes (s 292): "A trend is starting in Europe to integrate some alternative medicine into health care systems. A few countries have already passed the first step in the process of integrating complementary medicine, which is the recognition of their usefulness and perhaps even their necessity. Indeed, some countries do not only tolerate alternative practitioners, but they have built complete systems of education and examination for them. Some governments also either begin to include some reimbursement for complementary medicines in their social insurance schemes, or unofficially tolerate that some alternative treatments are being covered by public funds. At the same time, many private insurance companies propose policies including coverage for complementary medicine". (ref 3)

In 2001 the World Health Organization published a summary called "Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review" (ref 4), and in 2005 a "Global Atlas of Traditional, Complementary and Alternative Medicine" (ref 5). The reviews show that national recognition and regulation of traditional and complementary/alterative medicine varies considerably.

References

1. Stephan J. Traditional and alternative System of Medicines: A Comparative Review of Legislation. International Digest of health Legislation, 1985, Vol. 36, No. 2.

2. De Bijl N, Nederveen -Van de Kragt I. Legal safeguards against medical practise by not suitable qualified persons. European journal of health Law 1997; 4: 5-18.

3. Maddalena S. The legal status of complementary medicines in Europe. Berne: Universitè de Neuchâtel, Stæmpfli Publisher Ltd. 1999.

4. Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, (document WHO/EDM/TRM/2001.2). Geneva: World Health Organization, 2001.

5. WHO global atlas of traditional, complementary and alternative medicine. Kobe, Japan: World Health Organisation, the WHO Centre of Health Development, 2005.