Homeopathy Lecture Script In the past few classes, I’ve been dealing with a variety of conventional medical treatments for a number of the major common ailments that people experience. And now I’m going to be beginning a series of lectures on what people in Western culture call alternative medicines. Alternative medicines are commonly defined in western culture as therapies that have a cultural or a historical basis and may not have a scientific explanation for their effectiveness. Alternative medicines include acupuncture, herbal medicine, naturopathy, and so on. My particular topic today is one of the more controversial alternative medicines – homeopathy - with a focus on the regulation of homeopathy (Q.1). And I intend to devote much of my lecture today to the regulation of homeopathy in Canada. Now, all the time we’re dealing with homeopathy, I want you to think about whether or not it is legitimate medicine because some people have suggested it is not. Homeopathy has a lot of supporters – people who strongly believe that its medicines have cured them. But it also has critics – critics who have described it as quackery or pseudoscience or “a cruel deception” (Q.2). So you should be thinking about what makes a medicine legitimate, or genuine or real, and whether homeopathy is legitimate medicine, or just trickery, just bogus or a scam (Q.2), as its detractors say. Alright, now just to be clear, regulation means making rules for something, and here we’re talking about governments making those rules – governments making those regulations. What I want you to understand is that when a government chooses to regulate a profession or a substance such as a medicine, the citizens of that country will believe the profession or medicine can be trusted – that they are trustworthy (Q.3). If a government totally bans a professional or a medicine, then citizens understand that they’re dangerous or not reliable or untrustworthy, but regulating them gives credibility. Okay, turning to Canada, it is quite complicated because, as with many things in Canada, both federal and provincial governments have some responsibility. The federal government – the national government - establishes law on health issues for the entire Canadian population, and the 10 provincial and 3 territorial governments - that is, the local governments - act locally for their own populations. So: the federal level deals with regulations concerning dangerous products, food and drugs, inspections, etc. On the other hand, the provincial and territorial levels of government have the responsibility to safeguard health locally – for example, with hospitals, healthcare supervision, healthcare programs, and professional regulations (Q.4). So I’m going to start at the national level and here the federal government has authority by way of something called the Canadian Natural Health Care Products Regulations which came into effect on January 1, 2004 (Q.5). I’m going to refer to these regulations as the CNHCP, which is a little bit easier than saying the entire name each time. Now there are a few things I want to highlight for you from these regulations with regard to homeopathic remedies, and you should make sure you take notes on these at question 6 in your booklet. Ready? Okay. First, these are the regulations in which homeopathic remedies are included. So the CNHCP regulations cover homeopathic remedies. And, secondly, it’s important to notice this means that homeopathic remedies are not drugs. If they were, they would be regulated under the Food and Drug Regulations. So homeopathic remedies are not recognized as drugs by the Canadian government. That sets them apart from conventional medical drugs, of course, which are prescribed by medical doctors, do deal with and prescribe drugs. The third important aspect about homeopathic remedies is that they must be safe to be sold as over the counter products – meaning a person does not have to get a prescription from a medical doctor in order to buy them. So anyone can go to a pharmacy or a natural health care store, and buy a homeopathic remedy, but it must be safe. And a fourth point to notice is that this safety is guaranteed by the remedies’ inclusion in the CNHCP. Because all products listed are subject to a pre-market review before they may be sold in Canada. Finally, a homeopathic product will be issued a product licence with a Homeopathic Medicine Number – something called a DIN-HM - which must appear on the product label as proof that the Government has authorized it for sale (Q.6). And just to be absolutely clear before we leave the national scene, the pre-market review that is required on homeopathic remedies involves providing evidence of safety, quality and efficacy efficacy – remember that word – it means does it work. Does it do what it says it will do? (Q.7) Critics of homeopathy often base their criticism on efficacy. Anyway, let’s move on to the local state of affairs in Canada, and this is where it gets really complicated, because there is no one uniform picture of the situation. Remember I mentioned before that each province has responsibility for making regulations on professional practice. So here we’re not talking about the treatment remedies, but about the people who practice homeopathy. These people are called homeopaths. There is only one province which gives legal recognition to homeopaths and that is Ontario. In the province of Manitoba, the law does recognize homeopathy as something that a medical doctor can do – that is, a doctor with a medical degree from a university - but not anyone else. But Ontario gives legal regulatory recognition to homeopaths working in Ontario without medical degrees (Q.8). Let me just point out that the lack of legal recognition for homeopathy in much of the rest of the country does not mean practicing homeopathy is illegal, but it does mean there are no clear rules about it - for example, there are no clear rules on the qualifications of homeopaths or the manner in which they should proceed – and I think we could say that is definitely detrimental for patients. Only in Ontario has homeopathy been recognized in legal regulations as a profession. Creation of regulations for a profession is important because the regulations establish standards for the people who are in that profession. An example of these standards is requirements for homeopaths to keep up-to-date on new research. Another very important standard is educational qualifications. Others are rules on what can or cannot be done within the profession, and also methods of dealing with members who break the rules. So this final one is methods of dealing with members who break the rules (Q.9). Now, the Homeopathy Act in Ontario became law in June 2007 (Q.10), and Ontario established a College of Homeopaths. In case you’re confused here, college in this sense does not mean a school with faculty and students. It means a regulatory and advisory body with a common purpose and responsibilities. The purposes of the Ontario College of Homeopaths are: to recognize homeopaths as professionals, to govern the profession, to register homeopaths, and to ensure the public is protected (Q.10). Another purpose is to ensure homeopaths are trained and qualified (Q.10). The Ontario Homeopathy Act also restricts what homeopaths can do. For example, the Act does not allow homeopaths to perform what are called restricted medical acts – medical acts which can only be performed by medical doctors (Q.10). The scope, the limits, of the practice of homeopathy is defined as – and here I’m quoting - "...the assessment of body system disorders and treatment using homeopathic techniques to promote, maintain or restore health." That’s what homeopaths are allowed to do according to Ontario law. What the Ontario Homeopathy Act means for patients in Ontario is that they will be able to access a list of registered homeopaths (Q.10). So they can find a list of homeopaths who are registered in Ontario. It also means patients will have somewhere to complain if they are not satisfied with their treatment (Q.10). Now there’s another province I’d like to tell you about and that’s Quebec, and this is really interesting because homeopathy in Quebec has been going in quite a different direction from Ontario. And this essentially began in 1989 when an organization called the Professional Syndicate of Homeopaths of Quebec was formed. This organization is known as the SPHQ, which is from its French language name. The SPHQ had several purposes, one of which was to ensure legal protection for the quite small group of people who were practicing homeopathy in the province at the time. So one purpose was legal protection. The other purposes were to establish rules, to establish an ethics code and to set up a 1500 hour training program for homeopaths (Q.11). So you can see this was rather like the Ontario College of Homeopaths. It was an attempt to bring some professionalism to homeopathy in Quebec. However, medical doctors in the province were against the homeopaths who were members of the SPHQ because they did not have medical degrees (Q. 12). And the College of Medical Doctors asked the Quebec law courts to rule on the matter. And the Quebec law courts ruled that the practice of homeopathy violated the law requiring a medical licence, which only a doctor with a medical degree has. As a consequence of this legal ruling, the Government of Quebec enacted legislation so that today the practice of homeopathy in Quebec is legally limited to only medical doctors (Q.13). And finally and very briefly, I’d like to mention education for homeopaths in Canada. There is no university-level program in homeopathy recognized in Canada. Nor is there any program approved by any province. All homeopathic programs are currently offered by private colleges or private schools (Q.14. So there is no regulation of the education for homeopaths in Canada, no standardization of courses taught, etc. I have to say it’s certainly my opinion that some of the programs which are offered at the moment are not good quality (Q.15). Okay, I see our time is up. What I’d like you to think about before next class is who should be allowed to be a homeopath and whether homeopathy should be regulated (Q.16). I’ll see you next week.
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