Where is CAM legally regulated?

The extent to which countries have established a legal regulation of CAM and how such regulation is performed varies widely. Some countries have laws regulating CAM in general, some regulate specific CAM therapies, while still others have no CAM legislation at all (table 2). All countries without any CAM legislation except for the Netherlands, have an "all-regulated system".

Table 2: Legislation of CAM in European countries

Legislation

Number

Country

CAM legislation

7

Belgium (1999), Denmark (2004), Germany (1939)*, Hungary (1997), Iceland (2005), Norway (2004), Portugal (2003)

CAM legislation in preparation

5

Ireland, Luxembourg, Poland, Slovenia, Sweden

Legislation of some CAM therapies **

9

Czech Republic, Cyprus, Finland, Italy, Lithuania, Latvia, Liechtenstein, Malta, UK Great Britain

No CAM legislation

8

Austria, Estonia, France, Greece, The Netherlands, Spain, Slovakia, Switzerland***

* Regulation of Heilpraktiker
** See table 3
*** No national legislation in Switzerland, but cantons have legislation of some therapies

Table 3 shows details of the regulation of specific CAM therapies adopted by the European countries. To our knowledge 2/3 of the countries have some kind of regulation (ref 2). What type of CAM therapies that are regulated differs between countries, but the most commonly regulated are acupuncture, chiropractics and homeopathy. In some countries specific CAM therapies are defined as medical specialities (Not shown in the table).

Table 3: Specific CAM regulated providers in European countries by year of legislation

X: Year of legislation is unknown
Y: New law is in preparation

Countries

Regulating CAM providers by law

 

No

Yes

Chiropractics

Osteopathy

Naprapathy

Homeopathy

Acupuncture

Naturopathy

Phytotherapy

License

CAM register*

Austria

no

                 

Belgium

 

1999

1999

 

1999

1999

       

Cyprus

 

x

y

   

y

       

Czech Republic

       

2002

         

Estonia

no

                 

France

no

                 

Denmark

 

1992

             

2004

Finland

 

1994

1993

1994

           

France

   

2002

             

Germany**

               

1939

 

Greece

no

                 

Hungary***

               

1997

 

Iceland

 

1990

2005

           

2005

Ireland

no

               

y

Italy

 

x

               

Latvia (physicians)****

       

x

x

       

Liechtenstein

 

1985

               

Lithuania (physicians)****

       

x

         

Luxembourg

no

                 

Malta

 

x

x

   

x

       

The Netherlands

no

                 

Norway

 

1988

             

2004

Poland

no

                 

Portugal

 

2003

2003

 

2003

2003

2003

x

   

Spain

no

                 

Slovakia?

no

                 

Slovenia

no

                 

Sweden

 

1989

 

1994

         

y

Switzerland*****

               

x

 

UK

 

1994

1993

 

1950

y

 

y

 

x

Number

11

13

8

2

6

4

1

1

3

4

* The countries are offering voluntary registration schemes for CAM providers
** Germany is licensing Heilpraktikers who may provide CAM
*** Hungary is licensing CAM physicians and CAM practitioners
**** Physicians with a certificate from the university
***** In Switzerland chiropractics has been regulated by the cantons for many years. The government is planning a national regulation of Chiropractiss in the near feature. Osteopaths are regulated in 8 cantons. In 11 of the cantons, license is given Heilpraktikers as in Germany.

References

1. Johannessen H. Alternativ behandling i Europa. Århus: Viden- og forskningscenter for alternativ medisin. Mars 1995, revised Mai 2001.
2. Some information may be missing due to some countries missing response