Denmark
Summary (ref 1)
In Denmark anybody may treat but law restricts the scope of their activities. Chiropractics is regulated. A voluntary official registration scheme for those who practise CAM has been established.
Professionals and non-professionals
Legally regulated personnel
The Practise of Medicine Act of 1976 regulates the requirements for practising medicine and the authorisation of physicians. Physicians are allowed to use whatever techniques they choose, though the treatment has to be considered as responsible professional conduct. Practitioners of chiropractics were authorised in 1992 (ref 2) . The Danish Board of Health (Sundhetsstyrelsen) is responsible for supervising health services and authorised health personnel in the country.
Anybody may treat-
But some treatments are restricted to legally regulated personnel
The Practise of Medicine Act permits CAM providers to treat regardless of their training and without previous authorisation. However, non-Danish citizens who have not resided in Denmark for at least ten years may not practise complementary medicine.
The Practise of Medicine Act restricts specific medical procedures and treatment of certain diseases to authorised health personnel. Only health personnel may practise the following:
- Treat persons for venereal deceases, tuberculosis, or any other infectious diseases
- Perform surgery, administer total or local anaesthetics or provide obstetrics aid
- Apply medicines which may be dispensed only with physician’s prescriptions
- Use X-ray or radium treatments or therapies using electrical machines.
CAM providers are not permitted to use needles except under the supervision of an allopathic physician. This means that only allopathic physicians have legally provided acupuncture (Supreme Court 1981) (ref 3) . Violation of the limited monopoly of performing medical procedures and treating certain diseases result in an offence. However, non-allopathic providers may only be prosecuted for exposing patients to a provable danger, or causing them serious deterioration or death (ref 4).
Voluntary registration of CAM providers (ref 5)
In 2003 the Danish parliament passed a resolution to establish a federation administered register for CAM providers who are not medical doctors ("registered alternative practitioner"). The objective of the regulation is to contribute to safeguarding of the patient and to ensure the rights of consumers who seek registered CAM providers. Organisations approved by the government are given the task to register the providers. To be a "registered" CAM provider, the practitioners must have a membership in a practitioners’ organisation approved by the government and documented knowledge of basic medicines. The register was put into effect 01 June 2004. The register is voluntary and providers will be "self-regulated" through their member associations.
If CAM providers violate the legal rules, the authority or the patients can ask the police to investigate the matter. If CAM providers are "registered" according to the law, violation of the rules of the federation may exclude the person from membership in the federation.
The Practise of Medicine Act safeguards the patient when attending CAM providers, from being treated by unauthorised personnel in cases of some restricted medical procedures and diseases. If the patient seeks "registered" CAM providers, the safeguarding of the patient may be extended to areas comparable to the legal regulation of authorised health personnel. The safeguarding depends on the requirements set by the authorities when approving a federation.
Reimbursement
In general public reimbursement is not available for the use of alternative medicine. However, since 1975, a special agreement between the public insurance schemes and the chiropractors provides partial coverage. Furthermore, some reimbursements for acupuncture and osteopathic treatment are made when registered physicians refer patients. International Health Insurance, Denmark AS, distributes private insurance in Denmark and in several other European countries.
References
1. Referee for the chapter where nothing else is noted: Maddalena S. The legal status of complementary medicines in Europe. Berne: Universitè de Neuchâtel, Stæmpfli Publisher Ltd. 1999.Sundhetsstyrelsen, Denmark 06.09.05
2. Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, (document WHO/EDM/TRM/2001.2). Geneva: World Health Organization, 2001.
3. Ot.prp. nr 27(2002-2003) Om lov om alternativ behandling av sykdom mv. Norwegian Health Departement.
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. Act of Mai 19th 2004, No 351Bracheadministrert registreringsordning for alternative behandlere (Register for CAM providers) http://www.vifab.dk/alternativbehandling/regler_og_rettigheter or http://www/pkn.dk/lovsamling
