Transcript PRACTICE OF MEDICINE Defined - National Health Freedom

Diane Miller JD Copyright 2011
Top Health Freedom
State Issues
2011
Diane Miller JD, Director Law and Public Policy
National Health Freedom Coalition
www.nationalhealthfreedom.org
Diane Miller JD Copyright 2011
Law = Words
The Deciding
Voice of Freedom
in the United States
Diane Miller JD Copyright 2011
State
Federal
International
Diane Miller JD Copyright 2011
State Activism
“harnessing police power”
Local Level
PRACTITIONERS
GETTING SHUT DOWN
under STATE LAWS
For “practicing medicine without a license”
A CRIME!!!
Diane Miller JD Copyright 2011
PRACTICE OF MEDICINE
Defined
MICHIGAN
“"Practice of medicine" means the diagnosis,
treatment, prevention, cure, or relieving of a
human disease, ailment, defect, complaint, or other
physical or mental condition, by attendance, advice,
device, diagnostic test, or other means, or offering,
undertaking, attempting to do, or holding oneself
out as able to do, any
of these
acts.”
Diane Miller
JD Copyright
2011
PRACTICE OF MEDICINE
Defined
WASHINGTON
“…(1) Offers or undertakes to diagnose, cure,
advise, or prescribe for any human disease,
ailment, injury, infirmity, deformity, pain or other
condition, physical or mental, real or imaginary, by
any means or instrumentality;…”
RCW 18.71.011
Diane Miller JD Copyright 2011
WASHINGTON LAW
INVESTIGATIONS 07-08
Homeopath
Electrodermal screeners
Nutritional consultant
Colon hydrotherapist
Owner of homeopathic remedy Co.
Diane Miller JD Copyright 2011
Kansas Healing Arts
Not a Natural Right
65-2801
Chapter 65.--PUBLIC HEALTH
Article 28.--HEALING ARTS
65-2801. Purpose. Recognizing that the practice of the healing arts
is a privilege granted by legislative authority and is not a natural right of
individuals, it is deemed necessary as a matter of policy in the interests
of public health, safety and welfare, to provide laws and provisions
covering the granting of that privilege and its subsequent use, control
and regulation to the end that the public shall be properly protected
against unprofessional, improper, unauthorized and unqualified
practice of the healing arts and from unprofessional conduct by persons
licensed to practice under this act.
History: L. 1957, ch. 343, § 1; July 1.
Diane Miller JD Copyright 2011
PRACTICE OF MASSAGE
TEXAS
“…(c) A person may not for compensation perform
or offer to perform any service with a purported
health benefit that involves physical contact with
a client unless the person:
(1) holds an appropriate license issued
under this chapter; or
(2) is licensed or authorized under other
law to perform the service. …”
Texas HB2466
Diane Miller JD Copyright 2011
DOCTORS LOSING THEIR
LICENSES
Practicing outside of prevailing medical
practice
Grounds for Disciplinary Action
Medical Doctors Minnesota
“…. Unprofessional conduct shall include any
departure from or the failure to conform to
the minimal standards of acceptable and
prevailing medical practice in which
proceeding actual injury to a patient need
not be established…”
Minnesota Statute 147.091
Parents Forced to Agree to
Chemotherapy for their Children
“…(5) is medically neglected, which includes, but is not limited
to, the withholding of medically indicated treatment from a
disabled infant with a life-threatening condition. The term
"withholding of medically indicated treatment" means the
failure to respond to the infant's life-threatening conditions
by providing treatment, including appropriate nutrition,
hydration, and medication which, in the treating physician's
or physicians' reasonable medical judgment, will be most
likely to be effective in ameliorating or correcting all
conditions, except……”
Minnesota Statute Sec. 260C.007 Subd. 6 (5) 2009
Minnesota Forces Child to receive
Chemotherapy
State v. Danny Hauser
Minnesota
Child Protection Laws
“…except that the term does not include the failure to provide treatment
other than appropriate nutrition, hydration, or medication to an
infant when, in the treating physician's or physicians' reasonable
medical judgment:
(i) the infant is chronically and irreversibly comatose;
(ii) the provision of the treatment would merely prolong dying, not be
effective in ameliorating or correcting all of the infant's lifethreatening conditions, or otherwise be futile in terms of the survival
of the infant; or
(iii) the provision of the treatment would be virtually futile in terms of
the survival of the infant and the treatment itself under the
circumstances would be inhumane; ...”
Minnesota Statute Sec. 260C.007 Subd. 6 (5) 2009
RAW MILK DRINKERS
DEMAND ACCESS!
States mandate pasteurization of milk.
Some states have rigid requirements for farmers for retail sales of raw milk.
Minnesota and Missouri raw milk sales on farm are legal
Minnesota Food Freedom Project demanding the ability of farmers to
deliver the raw milk to consumers under direct farm to consumer
contracts.
SF147 and HF255
Good News !!
Health Freedom Victories!
Diane Miller JD Copyright 2011
STATE SAFE HARBOR
EXEMPTION LAWS
Nurses Minnesota
New Laws for
Traditional and unlicensed
practitioners
MN 146A Complementary and Alternative
Practices include but are not limited to:
(1) acupressure; (2) anthroposophy; (3) aroma therapy; (4) ayurveda; (5)
cranial sacral therapy; (6) culturally traditional healing practices; (7)
detoxification practices and therapies; (8) energetic healing; (9)polarity
therapy; (10) folk practices; (11) healing practices utilizing food, food
supplements, nutrients, and the physical forces of heat, cold, water, touch,
and light; (12) Gerson therapy and colostrum therapy; (13) healing touch;
(14) herbology or herbalism; (15) homeopathy; (16) nondiagnostic iridology;
(17) body work, massage, and massage therapy; (18) meditation; (19) mindbody healing practices; (20) naturopathy; (21) noninvasive instrumentalities;
and (22) traditional Oriental practices, such as Qi Gong energy healing.
Diane Miller JD Copyright 2011
Rhode Island Exemptions
“….(d) … persons in Rhode Island are authorized
to practice as unlicensed health care
practitioners and receive remuneration for
their services....”
Rhode Island 23-74-1
Diane Miller JD Copyright 2011
California New Law
Passed SB 577 in 2002
“…complementary and alternative
services do not pose a known risk to the
health and safety of California
residents,and that restricting access to
those services due to technical
violations of the Medical Practice Act is
not warranted. …”
Diane Miller JD Copyright 2011
Louisiana Health Freedom Coalition
Exempt from violations:
F. A person providing information or recommendations
for a fee who is acting under and in compliance with
this Section shall not be in violation of 30R.S. 37:127
for providing information or making
recommendations regarding food, dietary
supplements, or homeopathic remedies.
Underline added
Senate Bill No. 189, Act No. 334, 2005
Diane Miller JD Copyright 2011
Arizona Homeopathy 2008
This Chapter does not prevent:
10. The practice of providing treatment of the spiritual
vital force in accordance with Hahnemanian principles
through the use of remedies that are diluted beyond the
concentration of substances in drinking water and
prepared in the manner described in the Homeopathic
Pharmacopoeia Of The United States.
Arizona SB1236 Chapter 57 2008
Diane Miller JD Copyright 2011
State of DELAWARE
"(d) An herbalist, retailer or other person who does not hold himself
out to be a dietitian or nutritionist by using one or more of the
titles restricted by this chapter, who makes recommendations
regarding lifestyle, or who markets, distributes, sells, or who
recommends, advises, or furnishes non-fraudulent information
about, herbs, vitamins, minerals, amino acids, carbohydrates,
sugars, enzymes, food concentrates, foods, other food
supplements, or dietary supplements. For purposes of this
paragraph, fraud shall be defined as an intentional
misrepresentation for financial gain. Legitimate disagreement
about the role of the above listed nutrients and foods as they apply
to human nutrition shall not, in and of itself, constitute fraud.“
Diane
Miller JD Copyright
2011
Delaware
Freedom
Amendment
HB 38 2007
Minnesota Safe Harbor 146A
exempted out of
naturopathic doctor law
Nothing in this chapter may be construed to prohibit or to
restrict:
(1)…
(2) the provision of the complementary and
alternative healing methods and treatments,
including naturopathy, as described in
chapter 146A;
5th2011
Engrossment as signed by Gov May2008
Diane MillerMNHB1724
JD Copyright
2008 Minnesota
Naturopathic Medicine
Sec. 2. [147E.05] SCOPE OF PRACTICE.
Subdivision 1. Practice parameters. (a) The practice of naturopathic medicine includes, but is not
limited to, the following services:
(1) ordering, administering, prescribing, or dispensing for preventive and therapeutic purposes: food,
extracts of food, nutraceuticals, vitamins, minerals, amino acids,enzymes, botanicals and their
extracts, botanical medicines, herbal remedies, homeopathic medicines, dietary supplements and
nonprescription drugs as defined by the federal Food, Drug, and Cosmetic Act, glandulars,
protomorphogens, lifestyle counseling, hypnotherapy, biofeedback, dietary therapy, electrotherapy,
galvanic therapy, oxygen, therapeutic devices, barrier devices for contraception, and minor office
procedures, including obtaining specimens to assess and treat disease;
(2) performing or ordering physical examinations and physiological function tests;
(3) ordering clinical laboratory tests and performing waived tests as defined by the United States Food
and Drug Administration Clinical Laboratory Improvement Amendments of 1988 (CLIA);
(4) referring a patient for diagnostic imaging including x-ray, CT scan, MRI, ultrasound,
mammogram, and bone densitometry to an appropriately licensed health care professional to
conduct the test and interpret the results;
(5) prescribing nonprescription medications and therapeutic devices or ordering noninvasive
diagnostic procedures commonly used by physicians in general practice; and
(6) prescribing or performing naturopathic physical medicine.
(b) A registered naturopathic doctor may admit patients to a hospital if the naturopathic doctor
meets the hospital's governing body
requirements
regarding
credentialing and privileging process.
Diane
Miller JD Copyright
2011
MNHB1724 5th Engrossment as signed by Gov May2008
2010 Safe Harbor
Health Freedom States!
Oklahoma
Idaho
Minnesota
Rhode Island
California
Louisiana
Arizona (limited)
New Mexico!!
Diane Miller JD Copyright 2011
States that have introduced health
freedom bills 2004-2010!
Arkansas
Florida
Hawaii
Kentucky
Maryland
Michigan
Montana
New York
Ohio
Texas
Virginia
Colorado
Georgia
Iowa
Maine
Massachusetts
Nevada
North Carolina
Oklahoma
Utah
Washington
Diane Miller JD Copyright 2011
States that are preparing!
Connecticut
Kansas
Wisconsin
Delaware
Vermont
Diane Miller JD Copyright 2011
ME
WA
MT
ND
MI
MN
VT
N
H
NY
WI
MA
SD
OR
OH
WY
ID
NE
IA
PA
IL
IN
NV
UT
CO
WV
MD
KS
AR
AZ
NJ
D
E
MO
CA
NM
OK
homeopathy
VA
KY
TN
NC
LA
MS
AL
GA
SC
TX
FL
AK
Diane Miller JD Copyright 2011
HI
RI
CT
D
C
HOT SPOT STATES 2011
MI
WI
IA
NV
OH
CO
VA
AZ
homeopathy
NC
TX
Diane Miller JD Copyright 2011
HOT SPOT STATES 2011
Support
• Michigan Safe Harbor
• Texas HB 1716 Safe Harbor
• Ohio HF 442 Safe Harbor
• Wisconsin Safe Harbor
Oppose
• Arizona SB 1175 Homeopathic Doctor Licensure
• Nevada HB 289 Dietitian License
• Colorado HB 1173 NP defeated Feb 2011
• Iowa SB 1066 NP Licensing
• Virginia NP Licensing defeated Feb 2011
• North Carolina S 31Felony for practice of medicine
Diane Miller JD Copyright 2011
Diane Miller JD Copyright 2011
STATE EXPANDED CARE LAWS
Nurses Minnesota
New Laws for licensed
occupations.
Washington
Title 18 Business and Professions
Chapter 130
RCW 18.130.180
Unprofessional conduct.
“… (4) Incompetence, negligence, or malpractice which results
in injury to a patient or which creates an unreasonable
risk that a patient may be harmed. 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;…”
(Bold and color added)
New York Article 131
Non-conventional Medicine
“S 6527. Special provisions
This article 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.” (bold red added)
South Dakota 36-4-29.
Grounds for discipline
“36-4-29. ….the board may not
base a finding of unprofessional or
dishonorable conduct solely on the
basis that a licensee practices
chelation therapy.”
(red added)
Colorado 12-36-117
Alternative Medicine
“(3) (a) For purposes of this section, "alternative medicine"
means those health care 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. A licensee who practices alternative medicine shall
inform each patient in writing, during the initial patient
contact, of such licensee's education, experience, and
credentials related to the alternative medicine practiced by
such licensee. The board shall not take disciplinary action
against a licensee solely on the grounds that such licensee
practices alternative medicine. “
Minnesota Introducing
Expanded Care Model
Basic Principles
- Do not pose a greater risk
- Reasonable skill and safety
- Expanded Disclosures
“EXPANDED CARE PRACTICES”
Introduced in Minnesota HB 3213 (2006)
Federal Activism
“harnessing regulators”
Federal commerce
FDA
Definition of Drug
The term “drug” means
(A) articles recognized in the official United States Pharmacopoeia,
official Homeopathic Pharmacopoeia of the United States, or
official national Formulary, or any supplement to any of them;
and
(B) articles intended for use in the diagnosis, cure, mitigation,
treatment,or prevention of disease in man or other animals; and
(C ) articles (other than food) intended to affect the structure or any
function of the body of man or other animals; and
(D) articles intended for use as a a component of any article specified
in Clauses (A), (B) or (C ) of this paragraph. A food or dietary
supplement for which a claim ….”.
21 U.S.C. 321(g)1
Herbs in the U.S.
Herbs are Dietary Supplements - Foods
AND
Generally Regarded as Safe (GRAS)
Unless proven otherwise
Diane Miller JD Copyright 2011
Herbs in the U.S.
Regulate in the Least restrictive means
Presumption of Safety
Protect consumer access
Diane Miller JD Copyright 2011
Lower Court Ephedra Case
FDA lost
United States District Court for the District of Utah
April 13, 2005
Nuetracutical Corporation and Soloray Inc. v.
Lester Crawford FDA
Holding: The FDA, by failing to prove by a
preponderance of the evidence that a dosage of 10 mg or
less of ephedrine-alkaloids present a significant or
unreasonable risk of illness or injury, has failed to give
effect to the dose specific language of 21 U.S.C. Section
342 (f)(1)(A)(i).
Diane Miller JD Copyright 2011
Appeals Court Ephedra
FDA won
United States Court of Appeals, Tenth Circuit
August 17, 2006
Nuetracutical Corporation and Soloray Inc. v.
Lester Crawford FDA
Holding: The FDA correctly followed the congressional
directive to analyze the risks and benefits of EDS
(ephedrine-alkaloid dietary supplements) in determining
that there is no dosage level of EDS acceptable for the
market.
Diane Miller JD Copyright 2011
Pyridoxamine Vitamin B6
FDA won
Dietary Supplement
v. Drug
There is no verifiable, contemporaneous evidence
documenting that pyridoxamine dihydrochloride or any
other compound containing pyridoxamine as its active
moiety was marketed as a dietary supplement or as a
food prior to pyridoxamine's authorization for
investigation as a new drug under an IND. Accordingly,
a product containing pyridoxamine is not a dietary
supplement as defined in 21 U.S.C. 321(fl) and may not
be marketed as such.
Diane Miller JD Copyright 2011
Canada
Strauss Herb’s Yohimbe Bark
and Yohimbine
C.01.041(1.1) “…no person shall sell a substance
containing a Schedule F Drug unless:
(a) The sale is made pursuant to a verbal or written
prescription received by the seller…”
Diane Miller JD Copyright 2011
Canada
plants “containing” prescription drugs
“Green tea; black tea; ocoa; gotu kola; garlic; several
oils; chocolate; coffee; celery; lettuce; bananas;
oranges; lemons; wheat; oats; peas; soybeans; corn;
carrots…”
Diane Miller JD Copyright 2011
Congressmen Paul and Burton
Free Speech
H.R. 3395 FDA
H.R. 3394 FTC
PROTECTS THE RIGHT
TO TELL THE TRUTH ABOUT NUTRIENTS
Emord and Associates
Diane Miller JD Copyright 2011
H.R. 3395
You could describe a nutrient as
mitigating, treating, or preventing any
disease, disease symptom, or health-related
condition
If true and not mis-leading
Diane Miller JD Copyright 2011
2010
S 510 Food Safety bill
PASSED
The Tester-Hagan amendment exempts
producers who gross under $500,000 and
who sell more than half of their products
to:
a) consumers (with no restriction on
location)
b) restaurants or retailers who are
EITHER in-state or within 400 miles.
Diane Miller JD Copyright 2011
2010 H.R. 4913
Congressman Chappetz
INADEQUATE SOLUTION
Begging for Free Speech
“Legitimate scientific research”
Instead of
Truthful and not misleading
Diane Miller JD Copyright 2011
International Activism
“impacting global powers”
EU
Loss of Products
EU Traditional Herbal Medicines Directive
Licensing prohibitively expensive
Banned if not in use for 30 years in EU
Restrictions to registered herbalists
Fewer herbs available to practitioners
Diane Miller JD Copyright 2011
EU
Loss of Products
European Union Food Supplements Directive
Burden of proof misplaced
“Positive List”
This essentially puts the burden of proof on the
manufacturers to prove the safety of age-old nutrients
before they are allowed to go to market. This is different
than the U.S’s approach to dietary supplements where
the burden of proof of harm is on the government before
a food product can be blocked from the marketplace
Diane Miller JD Copyright 2011
Canada
Loss of Small Businesses
Canada
Natural Therapeutic Products
New category in addition to food
Loss of products off the market
Diane Miller JD Copyright 2011
New Zealand
Protected Sovereignty
Australia looked to harmonize
with New Zealand and more countries in the
future
New Zealand resisted and WON!!!!!
Diane Miller JD Copyright 2011
New Zealand
Protecting Sovereignty
Australia ANZTPA model predicted over
40% of the current products on the NZ
market would disappear.
Submission 4 page NZ Trust
Diane Miller JD Copyright 2011
New Zealand
Protecting Sovereignty
New Zealand Trust
and
New Health
Health Freedom Organizations working to
protect the people of New Zealand health
care options
Diane Miller JD Copyright 2011
CODEX
Diane Miller JD Copyright 2011
WHO is representing YOU?
We need to be at the table long term if we
plan to make a difference and protect
health freedom.
Diane Miller JD Copyright 2011
World
Health Freedom Assembly
Diane Miller JD Copyright 2011
World
Health Freedom Assembly
Diane Miller JD Copyright 2011
Assembly - Founders
Friends of Freedom International
Live Longer Educational Foundation
Kommittén för Alternativ Medicin
Citizens for Health
Healthkeepers Alliance
National Health Freedom Action
Sunshine Health Freedom Foundation
Native Americans
Alliance for Health Freedom Australia
Salud Natural A.G.
New Health
New Zealand Health Trust
National Health Freedom Coalition
Peter Helagson
Trueman Tuck
Birgitta Holmner
Jim Turner
Wendell Whitman
Clinton Miller
Joan Vandergriff
Mark Ravenhair
Michael Bending
Ronald Modra
David Sloan
David Sloan
Diane Miller
Diane Miller JD Copyright 2011
Canada
Canada
Sweden
USA
USA
USA
USA
USA
Australia
Chile
NZ
NZ
USA
International Declaration
of Health Freedom
Passed by World Health Freedom Assembly
and Advisory Organizations
September 30, 2006
Additional Courier Signatures
Diane Miller JD Copyright 2011
United States
Health Freedom Assembly
Diane Miller JD Copyright 2011
Need Leaders
Who understands health freedom?
Who wants health freedom?
Who teaches health freedom?
Who lives health freedom?
Diane Miller JD Copyright 2011
Build Health Freedom
Relationships
Brick by Brick
Diane Miller JD Copyright 2011
Principles
of
Health Freedom
Diane Miller JD Copyright 2011
Principle #1.
The fundamental right of selfdetermination of individuals, to be let
alone to survive on their own terms
and in their own manner.
Diane Miller JD Copyright 2011
Principle #2.
The freedom to perceive and to act
as one wishes to secure health and
survival.
-Speak freely
-Move about and associate freely
-Perceive, believe, meditate, and pray freely
- Practice the healing arts
Diane Miller JD Copyright 2011
Principle #3
The freedom to access who and what
one needs or prefers for ones health
and survival
Diane Miller JD Copyright 2011
Principle #4
The responsibility to do no harm
Diane Miller JD Copyright 2011
Principle #5
The responsibility to respectfully
tolerate diverse options in health,
healing, and survival choices.
Diane Miller JD Copyright 2011
Principle #6
The duty of corporations and institutions to be
trustworthy entities upholding health freedom
rights and liberties of members of the human
family, and abiding by health freedom
responsibilities.
Diane Miller JD Copyright 2011
Principle #6B
And in light of the special legal nature of
corporate entities and their systemic
impact on the human family, the duty to:
Diane Miller JD Copyright 2011
#6B -1
-honor and preserve the sovereign nature
of individuals, the sovereignty of the
United States; and avoid any negative
impact on the sovereignty of other nation
states;
Diane Miller JD Copyright 2011
#6B-2
-honor and preserve American financial
and cultural diversity and multicultural
systems, and avoid negative financial or
cultural impacts on other nation states;
Diane Miller JD Copyright 2011
#6B-3
-avoid creating or being monopolies, and
avoid the use of large monopolistic
ownership of resources to dominate
cultures, public policies, regulations and
laws;
Diane Miller JD Copyright 2011
#6B-4
-avoid dominant control of natural
resources, avoid the suppression of access
to natural resources, and avoid potentially
harmful modification or destruction of
natural resources; and
Diane Miller JD Copyright 2011
#6B-5
-avoid promotion of products, protocols, policies,
regulations, or laws, that would encourage unlimited
dependence on corporations and institutions, or that
would discourage, prohibit, or otherwise negatively
impact the ability or will of humans and local human
communities to survive and prosper without the
corporation of institution.
Diane Miller JD Copyright 2011
Principle #7
The duty of the government to protect
health freedom and to make no law or
public policy abridging health freedom or
its fundamental principles.
Diane Miller JD Copyright 2011
BE AN AGENT OF
CHANGE
Laws and customs must be
carefully reviewed, revised, and even
repealed if necessary, and new laws
created, to reflect the development,
evolution, and spiritual maturization of a
people.
-Diane Miller
Diane Miller JD Copyright 2011
Action Steps
TO PROTECT FREEDOM
Sign Up with a freedom group
Act or Volunteer to make freedom
happen in your state and country
Donate to health freedom workers
Diane Miller JD Copyright 2011
NATIONAL HEALTH FREEDOM
COALITION
A 501(c) 3 Educational Nonprofit Organization
NATIONAL HEALTH FREEDOM
ACTION
A 501 (c ) 4 Lobbying Organization
Diane Miller JD
Director of Law and Public Policy
PMB 218, 2136 Ford Parkway
St. Paul, MN 55116-1863
www.nationalhealthfreedom.org
E-mail: [email protected]
651-690-0732
Diane Miller JD Copyright 2011
Freedom to Heal
Diane Miller JD Copyright 2011
Freedom:
A
Sacred
Attitude
Towards
The
Experience
Of Life
Diane Miller
Diane Miller JD Copyright 2011