PREDSEDNIK ECH POZVAL SKUPŠČINO ZZS K PRENEHANJU DISKRIMINACIJE ZDRAVNIKOV

15.12.2014 00:00
Dr. Thomas Peinbauer, predsednik Evropskega odbora za homeopatijo (ECH) je pozval predsednika in poslance Skupščine Zdravniške zbornice Slovenije, naj sprejmejo odločitev o prenehanju diskriminacije in jemanju licenc zdravnikom, ki želijo zdraviti tudi s homeopatijo. To je nepravičen in nesorazmeren ukrep, ki nasprotuje osnovnim načelom „štirih svoboščin“ Evropske unije.
Na 73. redni seji Skupščine Zdravniške zbornice Slovenije, ki bo 17. decembra 2014, so na dnevni red uvrstili tudi točko »Sistemska ureditev zdravnikov, ki se ukvarjajo s homeopatijo«. Gradivo z naslovom »Sistemska umestitev zdravnikov, ki se ukvarjajo s homeopatijo« je pripravila doc. dr. Danica Pavlič Rotar, dr. med., predsednica Odbora ZZS za pravno-etična vprašanja. Poslanke in poslanci bodo odločali, ali naj se zdravnikom z licenco, ki imajo dodatna znanja iz homeopatije in bi želeli zdraviti s homeopatijo, odvzame licenca, ali naj se jim dopusti, da zdravijo s homeopatsko medicino.
 
Poziv dr. Thomasa Peinbauerja, predsednika Evropskega odbora za homeopatijo (ECH), ki ga je naslovil na predsednika in poslance Skupščine Zdravniške zbornice, v nadaljevanju objavljamo v celoti:
 
Dear Prim. asist. mag. Završnik, dr.med., President of the Medical Chamber of Slovenia,
Dear members of the Medical Chamber of Slovenia,
Dear colleagues!
 
On 17 December 2014 the Medical Chamber of Slovenia will have its 73th Regular Session of the Assembly of the Medical Chamber of Slovenia. We have been informed and are very pleased that it will also deal with the „regulation of medical doctors which additional qualification in homeopathy“.
 
It is well known that from a European point of view there is a rather unique and discriminatory situation regarding the regulation and practice of medical homeopathy in Slovenia. It seems that now the delegates of the Assembly will discuss and vote for the first time whether medical doctors with licence should be allowed to practise homeopathy.
 
Democratic processes give strong legitimation, but democratic processes also need the involvement of all stakeholders and the consideration of all possible information to come to a well-informed decision.
 
As European umbrella organisation of 40 medical homeopathic associations in 25 European countries, representing about 45.000 medical doctors with additional qualification in homeopathy, we would like to give you in the following some arguments which should be considered by the delegates before the voting:
 
Patient safety
 
The WHO Strategy on Traditional & Complementary Medicine 2014-2023 proposes two key goals:
 
• to support Member States in harnessing the potential contribution of CAM including homeopathy to health, wellness and people-centred health care, and
• to promote the safe and effective use of CAM through the regulation of practices and practitioners.
 
These goals will be reached by implementing three strategic objectives:
 
• building the knowledge base and formulating national policies;
• strengthening safety, quality and effectiveness through regulation; and,
• promoting universal health coverage by integrating T&CM services and self-health care into national health systems.
 
Building the knowledge base and formulating national policies
 
The annual Union work programme for European standardisation for 2015 (COM(2014) 500 final), published on 30 July 2014, states in section 3.2.23 on Healthcare services: “Patients require safe, high quality services in order to have confidence in healthcare systems throughout Europe. To develop European Standards, clinicians and representatives of regulatory authorities, research and development as well as accreditation and standardisation organisations should bring together their knowledge and experience. In order to manage complex healthcare systems in a consistent manner, specific horizontal aspects could be subject to standardisation requests to CEN in line with relevant Union legislation and policies on healthcare.”
 
ECH initiated the CEN/TC 427 process “Service provision for Medical Doctors with additional Qualification in Homeopathy” which was approved in August 2013 and is expected to be completed by 2016. CEN/TC 427 is the ideal platform to start formulating national policies.
 
Strengthening safety, quality and effectiveness through regulation
 
The EU funded CAMbrella report (Work package 2), published in 2012, deals with the Legal Status and Regulation of Complementary and Alternative Medicine in Europe. There are different models for how medical homeopathy is regulated in Europe on a national level at the moment. In Middle and Southern Europe homeopathy is primarily provided only by physicians. The practice of homeopathy outside of regulated health care is illegal and violations are considered an offence.
 
But as far as we know Slovenia is the only country where medical chamber withdraws doctors’ licenses if they practice homeopathy and prescribe homeopathic medicines. This is unjustified and disproportionate obstacle (discrimination) also to the freedom of movement of medical doctors and patients within the European Union (four freedoms’ in EU: free movement of goods, persons, services and capital).
 
The Austrian Medical Chamber accepted in 1993 the ECH-LMHI Medical Homeopathic Educational Standard as basis for the additional training of medical doctors in homeopathy which is offered by two homeopathic medical associations, the Österreichische Gesellschaft für homöopathische Medizin (ÖGHM) and the Ärztegesellschaft für Klassische Homöopathie (ÄKH). Since 1993 the Austrian Medical Chamber has issued about 650 ÖÄK Diploma in Complementary Medicine: Homeopathy.
 
There has always been a very close relationship between ÖGHM, ÄKH and the Slovenian Homeopathic Medical Society (Slovensko homeopatsko društvo), which is also member of ECH.
 
Slovensko homeopatsko društvo would be a reliable and competent partner for the Slovenian Medical Chamber.
 
The additional value of homeopathy and CAM
 
Complementary and Alternative Medicine (CAM) is now used by one out of two EU citizens. Thanks to EU funding of the CAMbrella project, we now know from its researches CAM is practised by approximately 150.000 doctors, homeopathy by 45.000 doctors in the European Union.
 
Homeopathy is a whole medical system that originated in Germany. The fundamental idea of homeopathy is the Similarity Principle, which implies that substances capable of causing disorder in healthy subjects are used as medicines to treat similar patterns of disorder experienced by ill people. Homeopathic medicines are aimed to direct and stimulate the body’s self-regulatory mechanisms. Homeopathy is highly individualized while taking into account the symptoms and signs of the disease, the patient’s physical build, personality, temperament and genetic predispositions.
 
It is increasingly recognised that homeopathy can greatly contribute to public health policies because:
 
• Homeopathy is aimed at restoring the patient’s own natural systems for fighting disease and maintaining health and is therefore highly relevant in chronic disease management.
• Homeopathy helps reduce the need of high-impact medical interventions and conventional prescription drugs and the long-term dependency on them.
• Homeopathy helps reduce the need of antibiotics, thus reducing the problem of antimicrobial resistance.
• Homeopathy is characterised by a high patient satisfaction, increased quality of life, and reduction of absenteeism.
• Homeopathy is mostly low-cost treatment and helps reduce the need for high-cost interventions
• Homeopathy is a safe treatment with hardly any adverse effects.
• There is increasing evidence for homeopathy's effectiveness and cost-effectiveness.
 
The practice of medicine consists of the ethical application of a body of knowledge, principles and methods known as medical science and these objective standards are the basis of medical licensure for European physicians.
 
These standards allow a wide degree of latitude in physicians’ exercise of their professional judgment and do not preclude the use of any methods that are reasonably likely to benefit patients without undue risk.
 
High quality homeopathic care warrants a full medical qualification, as well as a high quality training and qualification in homeopathy. Thus homeopathy is provided within a safe medical context and within a broader care plan, which includes, as a must the knowledge of conventional medical diagnosis, prognosis, and treatments. Homeopathy can often be an alternative to conventional therapies, at times it is a complement to other approaches, and at times it is not indicated like any specific medical method.
 
Patients have a right to seek any kind of care for their health problems and they have a right to know what can be expected of medical doctors with additional competence in homeopathy in their specific situation.
 
Although homeopathy offers a different approach to the concept of illness and its relationship to the patient, homeopathic doctors work in much the same way as their conventional colleagues. History, examination, and investigation are all in once in patient management.
 
Homeopathic doctors will bring to the consultation all the ethical and professional values, competence and responsibility that are expected of a medical practitioner; forming an all round assessment of the patient’s needs, and collaborating with other health care practitioners whose care the patient is already receiving or may need.
 
In 2005 the Lancet concluded that homeopathy is a placebo method. On 6 December 2014 Systematic Reviews published the following brandnew systematic review and meta-analysis on individualised homeopathy which tackles this conclusion:
 
Mathie RT, Lloyd SM, Legg LA, Clausen J, Moss S, Davidson JR, Ford I (2014) Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis. Systematic Reviews, 3:142, doi:10.1186/2046-4053-3-142. The abstract and full-text are available at: http://www.systematicreviewsjournal.com/content/3/1/142/abstract  
 
This review is unprecedented in its quality, a landmark in the history of homeopathy research.
 
We´d like to invite you to forward this open letter to all members of the Assembly of the Medical Chamber of Slovenia to come to a full-informed decision. Furthermore we offer to come to Slovenia personally to discuss and explain medical homeopathy to members of the Medical Chamber, National Medical Ethics Committee and all interested parties.
 
Yours sincerely,
 
Dr. Thomas Peinbauer
President ECH

 
To:
Prim. asist. mag. Jernej Završnik, dr. med., spec., President of the Assembly of the Medical Chamber of Slovenia
Members of the Assembly of the Medical Chamber of Slovenia

CC:
Mr. Borut Pahor, President of the Republic of Slovenia
Dr. Miro Cerar, President of the Government of the Republic of Slovenia
Ms. Milojka Kolar, Minister of Health of the Republic of Slovenia
Ms. Vlasta Nussdorfer, Human Rights Ombudsman
Prim. Andrej Možina, President of the Medical Chamber of Slovenia
Prof. Dr. Franc Strle, President of Medical Council and Secretary of the Section six – Medical Sciences of the Slovenian Academy of Sciences and Arts
Prof. Dr. Dušan Šuput, Dean of the Faculty of Medicine Ljubljana
Prof. Dr. Ivan Krajnc, Dean of the Faculty of Medicine Maribor
Dr. Božidar Voljč, President of the National Medical Ethics Committee
Prof. Dr. Pavel Poredoš, President of the Slovenian Medical Association
Mr. Konrad Kuštrin, President of the FIDES
Mr. Igor Muževič, President of the PRAKTIK.UM
Ms. Helena Mole, President of the SZZZZS
Ms. Helena Lovinčič, RTVSLO
Ms. Diana Zajec, Delo
Ms. Nina Knavs, Dnevnik
STA
Slovensko homeopatsko društvo
LMHI