Biomedical subjects
Publications and source records attributed to I Oepen.
A survey is given of legal deficiencies which are hindering efforts to promote safety in both drugs and therapy. Suggestions are given for possible solutions. They include medical training, critical reviews of the methods and cost arrangements in unconventional medicine, and informing the public.
In the sphere of environmental medicine--analogous to other fields like oncology and chronic diseases--not only proven and approved methods, but also unconvential methods are offered, without evidence of efficacy. The application of these methods has the possible consequence of wrong diagnosis and malpractice. Examples are discussed such as Kirlian photography, electroacupuncture according to Voll, bioresonance diagnosis/therapy, kinesiology, regulation therapy according to Rost, "clinical ecology" according to Runow with, among others, the provocation/neutralisation test, a vaccination therapy with E. coli and finally electrosmog as an environmental noxa. Concerning the admissibility of contested methods, statements of medical specialist societies, judgements, and the law of medical products are quoted. In conclusion, the question of the origin of the ideas and alleged results of unconvential medicine is followed up and conclusions are drawn.
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In 1976, the term of "special therapy methods", denoting homoeopathy, anthroposophical medicine, and phytotherapy, was incorporated into the German law concerning pharmaceutical preparations. This led to judicial consequences with regard to payment of costs by assistance and social insurance bodies. Among judgments delivered, there were also some regarding Voll's electro acupuncture and treatment with nosodes or thymus extracts. Reasons given by courts for deciding in the claimant's favour were: doubts concerning the meaning of "general scientific agreement" about a certain method as well as regarding the socalled "medical science clause" of social private insurance authorities, and competence of medical experts. Furthermore, special effects were wrongly attributed to these methods. On the other hand, reasons for refusal of claims were: lack of general scientific acknowledgment of a method and negligence of available conventional treatment possibilities. In the commentary, it is stated that refunding of costs for nonconventional medical treatment is neither justified nor helpful, because it favours power struggle, sectarianism, and envourages quackery and charlatans. It is to be hoped that forthcoming mutual harmonizing of EC rules will, in the true interest of patients, favour acceptance of uniform practice and criteria.
Unconventional, i.e. disputed medical methods are offered to many patients. However, the propagated effects of such methods could not be confirmed by controlled studies. So, neither any risk taken by the use of these methods, can be justified nor are any costs for treatment vindicated. In future, and contrary to the prevailing attitude, these facts should become a matter of more serious concern, the more so, as with harmonization of EG legal regulations, adaptation to those European countries in which unconventional medical methods are evaluated more critical than in Germany, is to be expected. The following methods are discussed in detail: regulation thermography, Lüscher's test, homeopathy, homeopathy autoblood therapy, nosoden therapy, acupuncture, magnetic field therapy, ozone therapy, Mora therapy, lymph drainage, management of symbiosis, and anthroposophical medicine.
Firstly, it is explained that doctors, in accordance with the "Bundesmantelvertrag" and the so-called "Wissenschaftsklausel" of private insurance companies, are required to attend to cost-saving treatment and prescriptions, and that these regulations are also valid with regard to unconventional medical methods and medications. Further, it is exemplified by quotations, how some adherents of unconventional methods assert excessive pretension towards the general public as well as in medical periodicals. Accordingly, high fees are asked, which is also illustrated by some examples. Finally, users as well as non-users of disputed medical methods are called upon to occupy themselves more intensively with these problems and not to leave their solution to insurance bodies and the courts.
A review is given of proved techniques for detection of individual characteristics in stains of blood and semen. Above all the results of German investigators are considered because these have mostly been insufficiently treated in the English-language literature, for instance papers concerning Gm and Km typing.
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Adherents of methods not based on scientific proof, especially the disciples of Huneke's "neural therapy", believe not only that foci represent local lesions, but also that they may cause remote effects. Therefore, in the opinion of these physicians, foci should be regarded as "fields of disturbance" with regulatory consequences, as described by Huneke and Pischinger. Thus when the diagnosis is in doubt, such "zones of interference" are searched for using function tests which are much in dispute. The most important of these "tests" are: electroacupuncture (Voll), the electro focus test (Glaser-Türk and Türk), neural therapy (Huneke) and thermoregulation (Schwamm). Moreover, it should be remembered that the adherents of the above-mentioned methods, on the basis of diagnoses worked out by the above techniques, will "cure" these foci, a serious matter. It is, therefore, recommended, that medical societies and medical and arbitration boards pay attention to this problem which also concerns unqualified practitioners. The results of such efforts should be published for the information of patients, doctors and insurance companies.
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After an enumeration of synonyms of "alternative medicine" the term "natural healing methods" is defined. As it transpires, not all methods so earmarked are "according to nature". Therefore, permission to doctors to assign this "specialism" to their qualifications as a supplementary faculty seems no longer justified. Some methods of so-called alternative medicine (e.g.acupuncture, and homoeopathy) are critically discussed. As a conclusion, the question wether an "alternative medicine" is required, can only be answered in the negative, because only one medicine employing serious methods and taking no undue risks, is needed.
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