By Jann Bellamy
I am happy to report some good news: chiropractors, naturopaths, acupuncturists and assorted other practitioners of pseudo-medicine didn’t fare too well in the 2013-2014 state legislative sessions.
We’ve been following their legislative efforts all year over at the Society for Science-Based Medicine. Some state legislatures meet in yearly sessions. At the end of the year, pending bills die with the session. Some meet only every other year. Others meet in two-year sessions and, in some of these, legislation introduced in one year carries over to the next year. All states with two-year sessions ended these sessions at the close of 2014, except New Jersey and Virginia. If you want to see how your state operates, several websites can help you: MultiState Associates, National Conference of State Legislatures and StateScape.
Chiropractors are already licensed in all 50 states and all of their practice acts permit the detection and correction of the non-existent subluxation. Having achieved that goal, the focus of chiropractic legislative efforts is to expand their scope of practice (the holy grail, for some, being primary care physician status), turf protection and mandates requiring insurance reimbursement or their inclusion in various activities, such as sports physicals, concussion treatment, and scoliosis detection programs.
The most interesting chiropractic bill, one from Oklahoma, didn’t fall into any of those categories:
Chiropractic physicians in this state shall obtain informed, written consent from a patient prior to performing any procedure that involves treatment of the patient’s cervical spine and such informed consent shall include the risks and possible side effects of such treatment including the risk of chiropractic stroke.
The Oklahoma Chiropractors’ Association thinks informed consent legislation is “dangerous.” According to Chris Wadell, President of the Oklahoma Board of Chiropractic Examiners, informed consent “isn’t needed”:
“We don’t hide from this but it just hasn’t been necessary to do it,” Wadell said. He insists that chiropractors are helping people and are being unfairly blamed for strokes after a patient’s neck is adjusted.
The bill was watered down to a “Task Force on Neck Manipulation.” It passed in the House but not the Senate.
Fortunately, a bill passed and was signed into law by the governor in Wisconsin requiring chiropractors (who already had a duty to obtain informed consent) to inform patients of reasonable treatment alternatives and the risks and benefits of those alternatives. It does not require disclosure of “extremely remote possibilities that might unduly alarm the patient.” The standard for determining what must be disclosed is that of a “reasonable chiropractor,” not what a “reasonable patient” would want to know. We’ll have to see whether chiropractors will inform patients of the risk of cervical manipulation from now on, since the official position seems to be that chiropractic cervical manipulation is not a cause of stroke at all.
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