Law and Magic Blog

Will Health Care Insurance Plans Include Complementary/Alternative Medicine Coverage?

So, have you thought about whether any of the health care bills would require that insurance plans cover alternative or complementary medical treatments? No? Check out this story from Newsweek magazine, which suggests that the CAM lobby has already made its arguments to the Hill.

Requiring insurers to cover therapies with unknown outcomes runs counter to the White House's push for medicine with a proven track record. The basic idea behind evidence-based medicine is that doctors ought to use treatments that have the best possible evidence that they work. What counts as the best possible evidence? Randomized clinical trials.... Clinical trials work fine for drugs, where trials can quantify and compare outcomes. But for alternative treatments, things like prayer or even yoga, the evidence gets much less clear; randomized trials are more difficult to conduct. "For drugs you have placebos and double-blinded studies," says Timmermans. "But you cannot have a placebo for testing behavioral interventions." So alternative treatments are essentially on an uneven playing field when it comes to evidence-based medicine. Timmermans admits that "it's not an equal-opportunity methodology."

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Requiring insurers to cover prayer treatment may be a bit too extreme for health-care reform. More interesting to explore though, are other forms of nontraditional medicine, floated in reform bills, that have a stronger claim to an evidence base. Take, for example, complementary and alternative medicine, a field often criticized for unproven therapies. Some 38 percent of Americans use some form of it. Moreover, the field has increasingly embraced traditional research methods. Just a decade ago, the government established a National Center for Complementary and Alternative Medicine. The center studies "alternative healing practices"—anything from the use of echinacea to treat colds, to acupuncture for irritable bowel syndrome—"in the context of rigorous science." They use that gold standard Timmermans mentioned: randomized, clinical trials.

Here's a link to the National Center for Complementary and Alternative Medicine.

Now, I admit to practicing yoga, off and on, and I think (I think) it helps me feel less stress and it helps me calm down after a long day of magical legalizing. I know it helps my flexibility, but then so would, I suspect, going back to my ballet exercises. I do feel better when I downward dog and make like a tree, even though I don't Om. It annoys the felines. But I don't try to bill my health insurance company for my trips to the yoga studio. I'm not certain there's cause and effect there. Hey, I tried feverfew for my migraines, too, but I didn't see any amelioration there. Zippo. One of my primary care physicians explained that outcome--there's no quality control in the feverfew you buy OTC. Better to rely on the meds the neurologist prescribes, and mirabile dictu, my migraines have decreased significantly over the past few years. Hooray for modern medicine and Big Pharma (waving imaginary flag).

Minnesota Teen Finishes Chemo Treatments, Is Doing Well

Daniel Hauser, the Minnesota teenager who left the state in May accompanied by his mother rather than undergo court-ordered chemotherapy, preferring a course of alternative medicine, then returned, has finished his radiation treatments, and is doing well, according to his physicians and his family. His parents believe that alternative medical treatments have also helped him. Read more here in an article dated September 4, 2009, from the Minneapolis Star-Tribune.

Neumanns Sentenced To Six Months In Death of Daughter

A Wisconsin judge has sentenced Dale and Leilani Neumann, convicted earlier this year of reckless homicide in the death of their daughter Madeline (Kara) to six months in jail each, to be served over a period of six years, and additional years of probation. Instead of taking Kara to a physician, the Neumanns prayed for her recovery when she fell ill. Kara died of complications from diabetes; health professionals said she could easily have been treated. The Neumanns will each serve a different month in jail per year, so that they can care for their other children, and the judge is requiring that a nurse examine the children regularly. He stayed the sentences pending appeal. Read more here. The Neumanns' attorney indicated that the couple does plan to appeal.

UK Advertising Standards Authority Upholds Complaint About Religious Ad's Statement Regarding "Blessed Oil"

The British Humanist Association (BHA) and two members of the public complained about an advertisement for the Universal Church of the Kingdom of God (UCKG) which included the following statement:

"My son was born with a heart problem. After a party he started bleeding from the mouth. I rushed him to hospital and the specialist said he had 16 loose arteries. He went into a coma, his heart stopped and both his lungs collapsed. Doctors and specialists expected him to die. At the UCKG I was given some blessed oil to anoint my son with. Now that his heart and lungs are better I thank the UCKG for all the spiritual support I received".

The ad further included the statement: "In accordance to the CAP Code, point 50.3, the UCKG HelpCentre's spiritual advice is to be seen as a complement to scientifically proven treatment you may be receiving. The UCKG does not claim to heal people but believes that God can through the power of faith. Always follow your doctor's instructions."

The BHA complained to the Advertising Standards Authority (ASA) of the United Kingdom that the ad implied that the blessed oil mentioned had some medicinal properties that could heal and the ASA investigated, asking the UCKG to substantiate the implied claims.

The UCKG responded:

1. UCKG pointed out that the testimonial stated clearly that the individual had received only 'spiritual support' from the church and that no other help was mentioned. They added that the reference to 'spiritual support' was previously suggested to them by the CAP Copy Advice team as an alternative to saying that the person received any sort of medical or physical help. UCKG said they had copies of the testimonial to demonstrate its authenticity.

2. UCKG stressed that it was not their intention to discourage anyone from seeking qualified medical advice as they did not offer any kind of advice for medical conditions, serious or otherwise. They pointed out that the disclaimer made clear that the spiritual support offered was to be used as a complement to scientifically proven treatment and that it added that a person should always follow their doctor's instructions.

3. UCKG believed that the reference to the CAP Code did not imply an endorsement of the ad, but merely that they offered prayer as a complement to other treatments. They said they had included the reference after referring a similar ad to the CAP Copy Advice team for advice.

The ASA considered that "the testimonial explained the medical difficulties experienced by the woman's son and that the medical staff involved in his treatment expected him to die. Although we considered that that made clear that proper medical treatment had been sought, we noted the testimonial also emphasised that UCKG had provided 'blessed oil' to anoint the child with before he subsequently recovered. We noted the UCKG argued that the ad made clear, in both the testimonial and explicitly in the footnote, that they offered only 'spiritual support' and noted UCKG had previously sought CAP Copy Advice over the use of the term. However, although we considered that it was a reasonable way to describe the support UCKG offered, the surrounding claims also went further. We considered that some readers were likely to infer from the ad as a whole that anointing oil had played some role in the sons recovery. Because UCKG had sent no evidence to support such an implication, we concluded that the ad was likely to mislead. On this point, the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness), 14.3 (Testimonials and Endorsements), 50.1 and 50.27 (Health & Beauty Products and Therapies)." Thus, the ASA ruled that the complaint should be upheld.


The ASA "noted the ad referred to a serious medical condition. Although the testimonial explained that the woman had sought medical treatment for her son's condition, we considered that, because some readers were likely to infer from the ad as a whole that anointing oil had played some role in his recovery, the ad could discourage people from seeking essential treatment by implying that the oil had a curative effect. We therefore concluded that the ad breached the Code. On this point, the ad breached CAP Code clause 50.3 (Health & Beauty Products and Therapies)....We noted the footnote stated "In accordance to the CAP Code, point 50.3 ..." and considered that readers were likely to infer from that that the ad complied with that CAP Code clause. We considered that that was likely to be seen as an endorsement by CAP, which was a breach of CAP Code clause 14.6, and concluded that the ad breached the Code. On this point, the ad breached CAP Code clause 14.6 (Testimonials and endorsements)....The ad must not appear again in its current form."

Read the entire ruling here. Here's coverage from a Guardian article.

What is interesting is that the ASA does not address the UCKG's defense, which is that it relied on the advice of the CAP Copy Advice team in constructing its advertisement. Note that the CAP Copy Advice team website says explicitly in response to questions about complaints lodged with the ASA and ASA adjudications:

Does seeking CAP Copy Advice prevent me from getting into trouble with the ASA?

It goes a long way towards doing just that and we know of no better way to prevent problems with the ASA.  But we cannot guarantee either that the ASA will see things exactly the same way as we do or that an ad will not provoke complaints that will be investigated by the ASA.

With more subjective issues such as taste and decency, public sensitivities change over time so the ASA might receive complaints about something that has not previously been a problem.  As part of the investigation process, the ASA will check if CopyAdvice was consulted.  The adviser who dealt with your enquiry will explain the potential problems that were identified and what the recommendations were for changes.  If it sees that you tried to avoid provoking complaints, the ASA will bear that in mind when reaching its decision.

What are the qualifications of the advisers?

Our advisers bring a wealth of experience ranging from law to advertising, finance, and environmental management.  They have been trained to fully understand the CAP Code and how it has been interpreted by the ASA in the past.  They keep abreast of complaints made to the ASA as well as all ASA adjudications, whether or not the ASA Council upheld the complaint.  It would be fair to say that no other service is better informed of the requirements and application of the non-broadcast advertising Codes than Copy Advice!

Please note: our advisers do not give legal advice.

 

In the UCKG case, the ASA does note that the Church sought the advice of the CAP Code advice team. "We ...noted UCKG had previously sought CAP Copy Advice over the use of the term. However, although we considered that it was a reasonable way to describe the support UCKG offered, the surrounding claims also went further." The problem for the UCKG seems to have been in the "going further," specifically in the close connection of the sentence about the "blessed oil" provided, which was more than just spiritual support, and the sentence about the recovery of the patient, and then with the addition of the note about the compliance with the Code.

 

Simon Says

In the current issue of New Humanist, an editorial supporting the cause of Simon Singh, defending himself against a defamation lawsuit brought by the British Chiropractic Association.

Desperately Seeking Radovan

In today's New York Times Magazine, a story about Radovan Karadzic, who used the alias Dragan Dabic, attempting to hide from the International Criminal Tribunal for the former Yugoslavia. During his period in hiding, Mr. Karadzic professed interest in alternative energy fields and alternative medicine and attained a certain celebrity, probably not a good idea for someone who wanted to avoid the attention of war crimes tribunals and investigative journalists. Read more here in Jack Hitt's article.

One Trial Over Faith Healing Ends, Another Begins

Two days after an Oregon jury found a father guilty of a misdemeanor for failing to seek medical treatment in the death of his fifteen month old daughter, a Wisconsin father goes on trial on similar and more serious charges. Dale Neumann faces trial for reckless homicide in the death of his daughter Madeline (Kara) Neumann. He and his wife Leilani failed to seek conventional medical treatment for Kara, relying instead on faith healing. Leilani was convicted of the charges earlier this year and could be sentenced to 25 years in prison.

The Oregon couple, Carl and Raylene Worthington, were acquitted of manslaughter charges, but the jury found Carl guilty of the misdemeanor charge.

Taxpayer Funded Studies of Alternative Medicine

MSNBC.com reports that the federal government has spent 2.5 billion dollars studying alternative medical cures over the past ten years and has concluded that almost none of them offer much hope for sufferers. Some exceptions: acupuncture, yoga, and ginger. Read more here. Is it time to pull the plug on such government-funded studies, especially in such hard economic times?

Try Out Alternative Treatments, But Only On the Advice Of Your Conventional Physician

More and more physicians and nurses are trying complementary and alternative medicines (CAM) in efforts to help patients, but agencies, consumer groups, and experts note that there can be risks to these treatments. The FTC is now acting to investigate complaints about ads for herbal supplements and cures. "Natural" doesn't necessarily mean safe, and herbal medications, like prescription meds, are still meds. Over the counter supplements could interact with prescription drugs. Choosing an alternative treatment instead of, rather than, in addition to, a conventional treatment, might mean worse outcomes for some patients. Read more here in an MSNBC.com story. Read more here about claims made in some advertisements about natural products.

Chiropractors On TV

Ah, it's Friday. Following up on the Simon Singh libel lawsuit, I was poking around looking for images of chiropractors on tv and in pop culture.

A piece on chiropractors and the image of chiropractic medicine on tv from chiroweb.com. Here's another favorable piece by Randy Southerland. Chiropractor Dany Morin objects to the portrayal of chiropractic medicine in the series Rescue Me in a post here.

One of the most obvious images of chiropractors on tv is that of Alan Harper on Two and a Half Men, the popular CBS sitcom. The gifted Jon Cryer plays Alan, the hapless brother of lecherous musician Charlie Harper (Charlie Sheen). Neither Alan's mother Evelyn (Holland Taylor), nor Charlie, nor Alan's ex-wives Judith (Marin Hinkle) nor Kandi (the crazily wonderful April Bowlby) think Alan is a "real doctor". Evelyn sometimes alludes to the fact that Alan couldn't get into a "real medical school"--a four year program--and had to settle for something "less." Alan, of course, is offended by this, particularly when his son Jake can hear her. Both ex-wives, who seem to have been happy to have lived off Alan's income for years, have now traded him in on other professional men--Judith for a pediatrician and Kandi (apparently) for the lawyer who handled both her and Judith's divorces.

But various guest stars, including Frankie (Jenna Elfman) in an episode called "That was Saliva, Alan", and Angie (Susan Blakely), in an episode called "If My Hole Could Talk" reassure Alan that his hands are magic and he is a "miracle worker."