For all the science geeks, let’s get one thing out of the way: homeopathy is bunk. A homeopathic remedy is about as likely to cure anything as Bill Gates’ poop water will cure C. difficile. Just so that’s out of the way.
For some, that’s enough to reject the current effort by the Transitional Council of the College of Homeopaths of Ontario to bring the Homeopathy Act, 2007 into effect this April. This legislation would bring homeopaths under the Regulated Health Professions Act in Ontario. However unscientific nature of homeopathy is we still need to decide what level of regulation is appropriate given the current levels of acceptance and activity among patients. And to answer that, we need to examine some of the pros and cons that come with self-regulation and the other alternatives.
There are the clear drawbacks. Recognizing homeopaths as a self-regulated profession legitimizes them as a health professional in society. It gives them an aura of propriety in the public’s eye and serves as a tacit acknowledgement that they are providing legitimate alternative or complement for medical treatment. We say that psychics are a form of entertainment, and people who act on a psychic’s advice do so at their own risk. The same is true if you take health advice from your mechanic or hairdresser or even your next-door neighbour. If homeopaths are not practicing a legitimate form of medicine, then maybe we shouldn’t elevate their status to healthcare professionals and require patients to act on their advice at their own peril. This form of self-regulation also means that oversight of this area is unlikely to be addressed through other means, such as consumer protection laws dealing with fraud or deceit. More on this latter point later. Finally, self-regulation will mean that the profession will be required to set up minimum standards of competence and homeopathy, which seems artificial and even deceitful give the vacancy of the practice.
On the other hand, there may be public health benefits to bring homeopaths under the regulatory framework. The difference between psychics and homeopaths after all is that homeopaths hold themselves out as persons who are able to provide patients with advice that is intended to be acted upon by the recipient with the goal of achieving a specific health outcome. That kind of relationship, however fraught with misinformation, ought to be intensely protected by law. Other health professionals are characterized as a relationship built on a strong foundation of trust where patients are consistently considered to be in the vulnerable position. That means health professionals are dutifully obliged to ensure they are consistently acting in the patient’s best interests and are not using their position of power and authority to their own advantage or to manipulate the patient. The homeopath-patient relationship may already be characterized similarly, but regulation makes it explicit. This ensures a strong level of protection for patients seeking health advice from homeopaths already.
That level of protection for patients also extends to the complaint process. The costs and intimidating nature of the legal process can be prohibitive for anyone seeking redress from the actions of a homeopath. Requiring homeopaths to set up a complaints process lowers some of those barriers. More importantly, appeals from the College are heard by a multidisciplinary board — the Health Professions Review and Appeal Board — which serves as an independent check on the various self-regulated professions to ensure that they are properly protecting the patient. Appeals to this board are often brought by self-represented clients and greatly reduces the friction for patients seeking due recourse. That’s a clear advantage to persons who are clearly in a vulnerable and trusting relationship, especially when it comes to sexual misconduct that is common across all health professions.
Finally, regulation doesn’t completely eliminate or overshadow other avenues of oversight. Indeed, classification as a health professional means that homeopaths may bolster the argument that homeopaths should be held to the standard of care that has been throughly described in the medical malpractice jurisprudence. And so, while the best thing for society as a whole would be the elimination of the homeopathy ideology altogether it remains, for now, an option that many patients seek out for their healthcare needs. Accepting that, there may indeed be benefits to regulating the practice while continuing to push for the public at large to recognize that it is completely useless.