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Legal Issues: STATE LAWS

Health Freedom States

The following states have laws that protect patient access to alternative therapies from licensed physicians:

Alaska | Colorado | Georgia | Indiana | Massachusetts | New York
North Carolina | Ohio | Oklahoma | Oregon | Texas | Washington


The following has law that protects patient access to alternative therapies from all licensed health care professionals:

Florida


The following states have regulations that protect patient access to alternative therapies from licensed physicians:

Louisiana | Nevada | Texas


The following states have enacted laws that protect patient access to EDTA Chelation, specifically, from licensed physicians:

Oklahoma | South Dakota | Louisiana


The following states license homeopathic practice for physicians already licensed in any state:

Arizona | Connecticut | Nevada.
(Note:
These links open new windows. The AZ site runs each subsection of law as a distinct URL. This URL is for Licensing qualifications -- the rest of Chapter 29 is accessed onsite by clicking on "Statutes" and scrolling though 32-2900s.)


(Naturopathy is licensed in 12 states: Alaska, Arizona, California Connecticut, Hawaii, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, and Washington)

 

Alaska
Alaska Statute, Section 08.64.326(a)(8)(A).

Professional incompetence, gross negligence, or repeated negligent conduct;

the board may not base a finding of professional incompetence solely on the basis that a licensee's practice is unconventional or experimental in the absence of demonstrable physical harm to a patient.

[Enacted June 14, 1990]

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Colorado

Colorado General Statute, Section 12-36-117. Unprofessional Conduct.

(3) (a) For purposes of this section, "Alternative Medicine" means those healthcare methods of diagnosis, treatment, or healing that are not generally used but that provide a reasonable potential for therapeutic gain in a patient's medical condition that is not outweighed by the risk of such methods.

The board shall not take disciplinary action against a physician solely on the grounds that such a physicians practices alternative medicine.

A physician who practices alternative medicine shall inform each patient in writing during the initial patient contact of such physician's education, experience, and credentials related to the alternative medicine practiced by such physician.

[Enacted August 1997]

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Florida
[The Florida law applies to all health care professions.]

Florida Statutes, 456.41 Complementary or alternative health care treatments.--

(1) LEGISLATIVE INTENT.--It is the intent of the Legislature that citizens be able to make informed choices for any type of health care they deem to be an effective option for treating human disease, pain, injury, deformity, or other physical or mental condition. It is the intent of the Legislature that citizens be able to choose from all health care options, including the prevailing or conventional treatment methods as well as other treatments designed to complement or substitute for the prevailing or conventional treatment methods. It is the intent of the Legislature that health care practitioners be able to offer complementary or3 alternative health care treatments with the same requirements, provisions, and liabilities as those associated with the prevailing or conventional treatment methods.

(2) DEFINITIONS.--As used in this section, the term:
(a) "Complementary or alternative health care8 treatment" means any treatment that is designed to provide patients with an effective option to the prevailing or conventional treatment methods associated with the services provided by a health care practitioner. Such a treatment may be provided in addition to or in place of other treatment options.
(b) "Health care practitioner" means any health care practitioner as defined in s. 456.001(4).

(3) COMMUNICATION OF TREATMENT ALTERNATIVES.--A health care practitioner who offers to provide a patient with a complementary or alternative health care treatment must inform the patient of the nature of the treatment and must explain the benefits and risks associated with the treatment to the extent necessary for the patient to make an informed and prudent decision regarding such treatment option. In compliance with this subsection:
(a) The health care practitioner must inform the patient of the practitioner's education, experience, and credentials in relation to the complementary or alternative health care treatment option.
(b) The health care practitioner may, in his or her discretion, communicate the information orally or in writtenform directly to the patient or to the patient's legal representative.
(c) The health care practitioner may, in his or her discretion and without restriction, recommend any mode of treatment that is, in his or her judgment, in the best interests of the patient, including complementary or alternative health care treatments, in accordance with the provisions of his or her license.

(4) RECORDS.--Every health care practitioner providing a patient with a complementary or alternative health care treatment must indicate in the patient's care record the method by which the requirements of subsection (3) were met.

(5) EFFECT.--This section does not modify or change the scope of practice of any licensees of the department, nor does it alter in any way the provisions of the individual practice acts for those licensees, which require licensees to practice within their respective standards of care and which prohibit fraud and exploitation of patients.

Florida Statutes section 381.026: Patient's Bill of Rights and Responsibilities.--
(4) RIGHTS OF PATIENTS.--Each health care facility or provider shall observe the following standards:
(d) Access to health care.--
1. A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, physical handicap, or source of payment.
2. A patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide such treatment.
3. A patient has the right to access any mode of treatment that is, in his or her own judgment and the judgmentof his or her health care practitioner, in the best interests of the patient, including complementary or alternative health care treatments, in accordance with the provisions of s. 456.41.

[Enacted on May 8, 2001]

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Georgia

Official Code of Georgia Annotated, Section 43-34-42.1.

(a) This section shall be known and may be cited as the "Access to Medical Treatment Act."

(b) Notwithstanding any other section of law, and except as provided in subsection (c) of this Code section, an individual shall have the right to be treated for any life threatening illness, disease or condition by a person licensed to practice medicine under this article with any investigational medical treatment that such individuals desires or the legal representative of such individual authorizes if such person licensed to practice medicine under this article has personally examined such individual and agrees to treat such individual.

(c) A person licensed to practice medicine under this article may provide any medical treatment to an individual described in subsection (b) of this Code section if:

(1) There is no reasonable basis to conclude that the treatment itself, when used as directed, poses an unreasonable and significant risk of danger to such individual; and

(2) The person licensed to practice medicine under this article has provided the patient with a written statement and an oral explanation, which the patient has acknowledged with the patient's signature or the signature of the patient's legal representative, that discloses the facts regarding the nature of the treatment., specifically including that the treatment offered is experimental, not approved by the FDA for such indication, and available alternatives, as well as the material risks generally recognized by reasonably prudent physicians of such treatment's side effects.

(d) The treatment of patients in compliance with this Code section by a person licensed to practice medicine under this article shall not by itself constitute unprofessional practice or conduct.

[Enacted April 22, 1997]

(Legislative intent, in bill introduction, explains that purpose of the bill is to "provide that individuals have the right to be provided with any medical treatment desired or authorized under certain conditions....")

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INDIANA
IC 25-22.5-1-2.1
Experimental or nonconventional treatment; protocols for treatment

Sec. 2.1. (a) An individual who consents under IC 34-18-12 may receive any experimental or nonconventional medical treatment if:
(1) a licensed physician has personally examined the individual and agrees to treat the individual;
(2) there is no reasonable basis to conclude that the medical treatment, when administered as directed, poses an unreasonable and significant risk of danger to the individual receiving the medical treatment; and
(3) the physician has provided the individual with a written statement and an oral explanation of the medical treatment that the individual has acknowledged by the individual's signature or the signature of the individual's legal representative and that discloses the following:
(A) That the medical treatment is experimental or nonconventional.
(B) That the drug or medical device has not been approved by the United States Food and Drug Administration for any indication.
(C) The material risks generally recognized by a reasonably prudent physician of the medical treatment's side effects.

(b) If the medical treatment is to be provided on an inpatient or outpatient basis at a hospital licensed under IC 16-21, then that type of treatment must have been approved by the governing board of the hospital or by a commitee of the hospital authorized by the governing board to approve the types of experimental or nonconventional medical treatments that may be provided at the hospital on an inpatient or outpatient basis.

(c) The medical licensing board shall develop protocols for medical treatments that are provided in a setting other than the inpatient or outpatient hospital setting specified in subsection (b). A physician who fails to comply with a protocol developed under this subsection shall be subject to discipline by the medical licensing board.

(d) This section does not require any person or organization to provide an individual with access to a medical treatment not otherwise commercially available to that individual.

(e) This section does not require: (1) an insurer; (2) a fraternal benefit society; (3) a nonprofit corporation; (4) a health maintenance organization (as defined in IC 27-13-1-19); (5) a preferred provider arrangement under IC 27-8-11; or (6) a limited service health maintenance organization (as defined in IC 27-13-34-4); to provide coverage or make payment beyond the terms and conditions of the contract for medical treatment authorized under this section.

As added by P.L.44-1998, SEC.2. Amended by P.L.49-1999, SEC.1.

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Louisiana
Louisiana has two forms of protection for CAM practices: the first was a law to assure access to EDTA Chelation Therapy from medical doctors which sunset in 2001, and the second is a regulation that protects access to all CAM therapies from medical doctors, with guidlelines.

AN ACT (sunset in 2001)
To enact R.S. 37:1285.3 and Part II-B of Chapter 4 of Title 40 of the Louisiana Revised Statues of 1950, to be comprised of R.S. 40:678, relative to the practice of medicine; to authorize the use of chelating agents and chelation thearapy by physicians; to provide for the nullity or rules and regulation in conflict with this grant of authority; and to provide for related matters.

Be it enacted by the Legislature of Louisiana:

Section 1. R.S. 1285.3 be it enacted by the Legislature of Louisiana

A. Until February 1, 2001, and as further provided in Subsection C of this Section, it shall be lawful in the state of Louisiana for a licensed physician to prescribe, dispense, administere, supply, sell, give, or otherwise make available to any patient any chelating agent or any form of chelation therapy for the treatment or prevention of any medical condition when the physician deems it in the best interest of the patient.

B. For the purposes of the Section, "chelating agent" shall mean any medication which is a parenteral or oral metal-binding and bioinorganic agent, For the purposes of the Section "chelation therapy" means a therapy to restore cellular homeostasis through the use of a parenteral or oral chelating agent. For the puroposes of this Act, "physician" shall mean a physician licensed to practice medicine in this state under the provisions of R.S. 37:1261 et seq.

C. In an effort to make alternative medical therapy available to the citizens of the state in the safest and most advantageous way possible, the Louisiana State Board of Medical lExaminers may choose to engage in a study of the utilization of chelation therapy. No rulemaking effort by the board on this topic shall commence until the board has completed such a study including but not limited to adequate public notice, solicitation of all interested parties, and submission of the required reportt, all as in provided for under the provisions of the Administrative Procedure Act. No such report shall be submitted to the legislature prior to February , 2001, unless there is clear and convincing scientific evidence tha the actual use of chelation therapy produces harmful side effects or individuals receiving this form of therapy.

Section 2. Part II-B of Chapter 4 of Title 40 of the Louisiana Revised Statues, comprised of R.S. 40.678 is hereby enacted to read as follows:

All propsed rules in the subject of chelation therapy previously published as a notice of intent in the louisiana Regeister and any and all rules and regulations promulgated by the Department of Health and Hospitals, Board of Medical Examiners in conflict with the provision of Section 1 and 2 of the Act are hereby declared null, void, and of no effect.

Enacted July 1999.

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and


Title 46, Professional and Occupational Standards, Chapter 41. Integrative and Complementary Medicine. [These regulations are very lengthy and we have only excerpted certain parts. The full regulations including the intent, reporting requirements, advisory committee, and fiscal impact can be read as a pdf file at the Louisiana Register site --the link opens a new window to page 1936, scroll down to page 1951.]

Section 7103. Definitions
Integrative or Complementary Medicine diagnostic methods or therapies offered or employed by a physician, or under his on-site supervision and direction, in addition or as an alternative to conventional medicine methods or therapies, in the diagnosis, prevention or treatment of and illness, disease or condition which do not, in the judgment of the physician, pose a safety risk for a patient that is unreasonable greater than conventional medicine methods or therapies and provided there exists a reasonable probability for diagnostic or therapeutic effectiveness in its intended use. Integrative or complementary medicine does not include the use of controlled substances in the treatment of patients suffering from chemical dependency.

Section 7105 General Conditions/ Prohibitions
The use of integrative or complementary medicine for the diagnosis or treatment of any illness, disease or condition, constitutes legitimate medical therapy when provided in the course of professional medical practice, complies with the standard of care applicable to conventional medicine practitioners, and when fully documented in the patient's medical record. Any physician utilizing integrative or complementary medicine shall do so with strict compliance the rules enumerated in this Chapter.

Section 7107
Use of Integrative or Complementary Medicine; Limitations
Requisite Prior Conditions.
Any physician offering or utilizing integrative or complementary medicine shall comply with the following rules:

1.Evaluation of the Patient. Prior to offering integrative or complementary medicine, a physician shall perform an evaluation of the patient that shall include but not be limited to any conventional methods of diagnosis which, in the judgment of the physician, are deemed necessary or appropriate to the condition of the patient. Such evaluation shall include
a. a relevant medical history; and
b. an appropriate physical examination; and
c. a review of any relevant diagnostic studies or therapies undertaken or previously attempted.

2. Medical Diagnosis. A medical diagnosis shall be established by the physician and documented in the patient's medical record, which indicated the nature of the patient's illness, disease, condition or;other reason for which treatment is being sought if determinable.

3. Treatment Plan. A treatment plan by which progress or success can be evaluated with stated objective shall be formulated by the physician which is tailored to the individual needs of the patient and documented in the patient's medical record. Such a plan shall include documentation of:
a. whether conventional or complementary methods or diagnosis or treatment have been considered, are being undertaken or have been attempted without adequate or reasonable success or a statement that the patient has refused such methods;
b. consideration for the need for conventional testing, consultation, referral or treatment where indicated;
c. the intended role of integrative complementary medicine within the overall plan; and
d. whether integrative or complementary medicine offered or utilized could interfere with any ongoing conventional therapy.

4. Informed Consent. A physician shall inform a patient or his guardian of each of the following, which discussions shall be noted in some form in the patient's record:
a. his education, experience and credentials regarding any integrative or complementary medicine which is recommended; and
b. the risks and benefits of both conventional medicine and integrative or complementary medicine incorporated within each treatment plan.

(Enacted though publication in the Louisana Register, November 2001, pages 1951-1954.)

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Massachusetts

Massachusetts General Law Annotated, Chapter 112, Section 7.

Section two to six, inclusive, and section eight shall not be held to discriminate against any particular school or system of medicine.

[Enacted in 1901]

(Unlike similar old non-discrimination statutes in California and Texas, the Massachusetts law has been and continues to be upheld as a health freedom law.)

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Nevada

Chapter 630 of Nevada Annotated Code [Regulation]

1. A licensee shall not practice medicine by utilizing any means or instrumentality that has a risk for a patient that is unreasonably greater than the means or instrumentality ordinarily utilized by physicians in good standing practicing in the same specialty or field or that is provided as a substitute for conventional treatment that has proven to be of substantial benefit to the patient.

2. Subject to the conditions hereinafter set forth, a licensee may practice medicine by utilizing any means or instrumentality that is not prohibited by this section. Failure to practice by such means or instrumentality in conformity with the following conditions is grounds for disciplinary action:

(a) Prior to offering advice about the means or instrumentality of treatment, the licensee shall undertake an assessment of the patient. This assessment should include but not be limited to, conventional methods of diagnosis ordinarily utilized by physicians in good standing practicing in the same specialty or field, and may include non-conventional methods of diagnosis which shall be documented in the patient’s chart. Such assessment shall include the following:
(1) An adequate medical record;
(2) Documentation as to whether such conventional treatment options ordinarily utilized by physicians in good standing practicing in the same specialty or field have been discussed with the patient and shall include referral input, if necessary;
(3) Documentation as to whether such conventional treatment options have been tried, and if so, with what results, or a statement as to whether conventional treatment has been refused by the patient;
(4) If a treatment is offered which is not considered to be conventional, documentation of informed consent for each treatment plan must be included (including documentation that the risks and benefits of the use of both the conventional and the other means or instrumentality of treatment were discussed with the patient or guardian);
(5) A review of the current diagnosis and conventional treatment and documentation as to whether the other means or instrumentality of treatment could interfere with any other ongoing conventional treatment.

(b) The licensee may offer the patient other means or instrumentality of treatment other than conventional treatment pursuant to a documented treatment plan tailored for the individual needs of the patient by which treatment progress or success can be evaluated with stated objectives such as pain relief and/or improved physical and/or psychosocial function. Such a documented treatment plan shall consider pertinent medical history, previous medical records and physical examination, as well as the need for further testing, consultations, referrals, or the use of other treatment modalities.

(c) The licensee may use the means or instrumentalities of treatment other than conventional treatment subject to documented periodic review of the patient’s care by the licensee at reasonable intervals in view of the individual circumstances of the patient in regard to progress toward reaching treatment objectives which takes into consideration the treatment prescribed, ordered or administered, as well as any new information about the etiology of the complaint.

(d) Complete and accurate records of the care provided including the elements addressed in paragraphs (2)(a)(1) through (2)(a)(5) of this section shall be kept.

3. For purposes of this section, conventional treatment means those health care methods of diagnosis , treatments, or interventions that are offered by most licensed physicians as generally accepted methods of routine practice, based upon medical training, experience and review of the peer reviewed scientific literature, and which are ordinarily utilized by physicians in good standing practicing in the same specialty or field.

Adopted August 26, 2000 by the Nevada State Board of Medical Examiners
(Conflicting regulation penalizing a licensee who would "Treat any patient in a manner not recognized scientifically as being beneficial" was repealed by the same regulatory act.")

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New York
The New York act, Chapter 558 of 1994, amended one section of the education law and two sections of the public health law:

Education Law, Section 6527(4).

(4) This article [Article 131.] shall not be construed to affect or prevent the following:

(e) The physician's use of whatever medical care, conventional or non-conventional, which effectively treats human disease, pain, injury, deformity, or physical condition.

and

Public Health Law, Section 230, Subdivision 1.

A state board for professional medical conduct is hereby created. . . not fewer than 2 of whom shall be physicians who dedicate a significant portion of their practice to the use of non-conventional medical treatments who may be nominated by New York state medical associations dedicated to the advancement of such medical treatments. . .

and

Public Health Law. Section 230, Subdivision 10(a) Investigation. (ii) If the investigation of cases referred to an investigation committee involves issues of clinical practice, medical experts shall be consulted. Experts may be made available by the state medical society of the state of New York, county medical societies and specialty societies, and by New York state medical associations dedicated to the advancement of non-conventional medical treatments.

[Enacted July 26, 1994]

(Note: New York utilizes legislative intent to clarify terms of laws, in this case, effectively treats is clarified to mean "has been shown to be effective but has not yet gained general acceptance in the United States.")

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North Carolina

North Carolina General Statute, Section 90-14(a)(6).

Unprofessional conduct. . . The Board shall not revoke the license of or deny a license to a person solely because of that person's practice of a therapy that is experimental, nontraditional, or that departs from acceptable a prevailing medical practices unless, by competent evidence, the Board can establish that the treatment has a safety risk greater than the prevailing treatment or that the treatment is generally not effective.

[Enacted June 29, 1993]

And, more recently:

North Carolina General Statute, Section 90-2 Medical Board.
(a) In order to properly regulate the practice of medicine and surgery for the benefit and protection of the people of North Carolina, there is established the North Carolina Medical Board. There is established the North Carolina Medical Board to regulate the practice of medicine and surgery for the benefit and protection of the people of North Carolina. The Board shall consist of 12 members. (1) Seven of the members shall be duly licensed physicians elected and nominated to the Governor by the North Carolina Medical Society. (2) Of the remaining five members, all to be appointed by the Governor, one shall be a duly licensed physician who is a doctor of osteopathy or a full- time faculty member of one of the medical schools in North Carolina who utilizes integrative medicine in that person's clinical practice or a member of The Old North State Medical Society...

§ 90-2.1. Integrative medicine defined. For purposes of this Article, the term "integrative medicine" means a diagnostic or therapeutic treatment that may not be considered a conventionally accepted medical treatment and that a licensed physician in the physician's professional opinion believes may be of potential benefit to the patient, so long as the treatment poses no greater risk of harm to the patient than the comparable conventional treatments.

90-14. 90-14(g) Prior to taking action against any licensee who practices integrative medicine for providing care not in accordance with the standards of practice for the procedures or treatments administered, the Board shall consult with a licensee who practices integrative medicine.

Approved August 1, 2003

 

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Ohio

Section 4731.227 of the Ohio Revised Code:

AN INDIVIDUAL AUTHORIZED TO PRACTICE MEDICINE AND SURGERY OR OSTEOPATHIC MEDICINE AND SURGERY MAY USE ALTERNATIVE MEDICAL TREATMENTS IF THE PHYSICIAN PROVIDES THE NECESSARY INFORMATION IN ORDER TO OBTAIN INFORMED CONSENT FROM THE PATIENT AND THE TREATMENT MEETS THE STANDARDS ENFORCED BY THE STATE MEDICAL BOARD PURSUANT TO SECTION 4731.22 OF THE REVISED CODE AND ANY RULES ADOPTED BY THE BOARD.

AS USED IN THIS SECTION, "ALTERNATIVE MEDICAL TREATMENT" MEANS CARE THAT IS COMPLIMENTARY TO OR DIFFERS FROM CONVENTIONAL MEDICAL CARE BUT IS REASONABLE WHEN THE BENEFITS AND RISKS OF THE ALTERNATIVE MEDICAL TREATMENT AND THE CONVENTIONAL CARE ARE COMPARED.

[Enacted July 10, 2000]

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Oklahoma

Oklahoma has protection by two laws. The first was passed in 1983 specific to EDTA Chelation in Tort Law, and the second was passed in 1994 for all CAM in medical practice law.

The 1983 Chelation statute:
Statute Title 76,

76- 20.1 Healing Arts - Standard of Care.
The standard of care required of those engaged in the healing arts within the State of Oklahoma shall be measured by national standards.

76-20.2 Chelation or other authorized therapy not prohibited.
Nothing in the above act shall be construed to prohibit the use of EDTA chelation therapy or any other therapy or treatment authorized by law.


The 1994 medical practice statute:

Statute Title 59, Section

59- 492(F) Nothing in the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act shall prohibit services rendered by any person practicing nonallopathic healing practice.

and

59-493.1(M) The Board shall not deny a license to a person otherwise qualified to practice allopathic medicine within the meaning of this act solely because the person's practice or therapy is experimental or nontraditional.

and

59-509.10(2) The Board may take disciplinary action . . . . The Board shall not revoke the license of a person otherwise qualified to practice allopathic medicine within the meaning of this act solely because the person's practice is experimental or nontraditional.

[Enacted June 8, 1994]

(Legislative intent section [OS59.480] explains that allopathic medicine does not include homeopathy.)

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Oregon

Oregon Revised Statutes, Section 677.190, Subsection (1) Unprofessional Conduct.

(b) For purposes of this subsection, the use of an alternative medical treatment shall not by itself constitute unprofessional conduct. For the purposes of this paragraph:

1. "alternative medical treatment" means:

(i) A treatment that the treating physician, based on the physician's professional experience, has an objective basis to believe has a reasonable probability for effectiveness in its intended use even if the treatment is outside recognized scientific guidelines, is unproven, is no longer used as a generally recognized or standard treatment or lack approval of the United States Food and Drug Administration;

(ii) A treatment that is supported for specific usages or outcomes by at least one other physician licensed by the Board of Medical Examiners; and

(iii) A treatment that poses no greater risk to a patient than the generally recognized or standards treatment.

(B) "Alternative medical treatment" does not include use by a physicians of controlled substances in the treatment of a person for chemical dependency resulting from the use of controlled substances.

[Enacted May 30, 1995]

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South Dakota

Professions and Occupations Statute

36-4-29. Grounds for cancellation, revocation, suspension or limitation of license. The South Dakota State Board of Medical and Osteopathic Examiners may cancel, revoke, suspend or limit the license of any physician, surgeon or osteopathic physician or surgeon issued under this chapter upon satisfactory proof in compliance with chapter 1-26 of such a licensee's gross incompetence, or unprofessional or dishonorable conduct or proof of a violation of this chapter in any respect. However, the board may not base a finding of unprofessional or dishonorable conduct solely on the basis that a licensee practices chelation therapy.

Enacted July 1, 1993

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Texas

Texas enjoys protection in three forms: A consitutional provision, an early law still on the books, and as of October 24, 1998, a regulation. We at Healthlobby did not consider TX to be a Health Freedom State until the new regulation, because our research showed that the existing consitutional and statutory protections were not being enforced. The new regulations should accomplish that.


Constitution of the State of Texas. Article 16, §31.

The Legislature may pass laws prescribing the qualifications of practitioners of medicine in this state, and to punish persons for mal-practice, but no preference shall ever be given by law to any schools of medicine.

[Enacted in 1846]

("Schools of medicine" has been settled by the Texas Criminal Court of Appeals to mean "system, means, or method employed or schools of thought accepted by practitioner" Ex parte Halsted, 182 S.W.2d 479, 1944.)

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and


Texas Medical Practices Act: TMPA §3.06

Construction. (a): Nothing in this act shall be construed so as to discriminate against a school or system of medical practice. . .

[Enacted in 1907]

(This act consolidated multiple state medical boards. Therapeutic distinctions of homeopathy, eclectic and naturopathy were considered to be additions to the basic allopathic "science" required of all licensees.)

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and


Texas Administrative Code: 22 TAC §§200.1-200.3 [regulation]

Standards for Physicians Practicing Integrative and Complementary Medicine

§200.1. Purpose. The purpose of this chapter is to recognize that physicians should be allowed a reasonable and responsible degree of latitude in the kinds of therapies they offer their patients. The Board also recognizes that patients have a right to seek integrative or complementary therapies.

§200.2. Definitions. The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise.

(1) Integrative and Complementary Medicine- Those health care methods of diagnosis, treatment, or interventions that are not acknowledged to be conventional but that may be offered by some licensed physicians in addition to, or as an alternative to, conventional medicine, and that provide a reasonable potential for therapeutic gain in a patient's medical condition and that are not reasonably outweighed by the risk of such methods.

(2) Conventional Medicine - Those health care methods of diagnosis, treatment, or interventions that are offered by most licensed physicians as generally accepted methods of routine practice, based upon medical training, experience and review of the peer reviewed scientific literature.

§200.3. Practice Guidelines for the Provision of Integrative and Complementary Medicine. A licensed physician shall not be found guilty of unprofessional conduct or be found to have committed professional failure to practice medicine in an acceptable manner solely on the basis of employing a health care method of integrative or complementary medicine, unless it can be demonstrated that such method has a safety risk for the patient that is unreasonably greater than the conventional treatment for the patient's medical condition. The Texas State Board of Medical Examiners will use the following guidelines to determine whether a physician's conduct violates the Medical Practice Act, §§3.08(4), 3.08(4)(E), and 3.08(18) in regard to providing complementary and integrative medical treatment.

(1) Prior to offering advice about complementary health care therapies, the physician shall undertake an assessment of the patient. This assessment should include but not be limited to, conventional methods of diagnosis and may include non-conventional methods of diagnosis and shall be documented in the patient's chart. Such assessment shall include the following listed in subparagraphs (A)-(E) of this paragraph:
(A) adequate medical records as defined in §165.1 of this title (relating to Medical Records);
(B) documentation as to whether conventional medical treatment options have been discussed with the patient and referral input, if necessary;
(C) documentation as to whether conventional medical options have been tried, and if so, to what effect or a statement as to whether conventional options have been refused by the patient;
(D) if a treatment is offered which is not considered to be conventional, documentation of at least a verbal informed consent for each treatment plan must be included (including documentation that the risks and benefits of the use of the treatment were discussed with the patient or guardian);
(E) documentation as to whether the complementary health care therapy could interfere with any other ongoing conventional treatment.

(2) The physician may offer the patient complementary and integrative treatment pursuant to a documented treatment plan tailored for the individual needs of the patient by which treatment progress or success can be evaluated with stated objectives such as pain relief and/or improved physical and/or psychosocial function. Such a documented treatment plan shall consider pertinent medical history, previous medical records and physical examination, as well as the need for further testing, consultations, referrals, or the use of other treatment modalities.

(3) The physician may use the treatment subject to documented periodic review of the patient's care by the physician at reasonable intervals in view of the individual circumstances of the patient in regard to progress toward reaching treatment objectives which takes into consideration the treatment prescribed, ordered or administered, as well as any new information about the etiology of the complaint.

(4) Complete and accurate records of the care provided including the elements addressed in paragraph (1)(A)-(E) of this section should be kept.

(5) If the provisions set out in paragraphs (1)-(4) of this section are met, and if all treatment is properly documented, the board will presume such practices are in conformity with the Medical Practice Act, §§3.08(4), 3.08(4)(E), and 3.08(18).

[Adopted October 24, 1998]

(Board's intent is discussed the Preamble to Agency Rules)

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Washington

Washington Revised Code Annotated, Section 18.130.180(4).

Incompetence, negligence or malpractice. . . . The use of a nontraditional treatment by itself shall not constitute unprofessional conduct, provided that it does not result in injury to a patient or create an unreasonable risk that a patient may be harmed.

[Enacted May 21, 1991]

 

 

 

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Updated: 2/14/2002
Contact: Monica@healthlobby.com