BMJ  2004;328:485 (28 February), doi:10.1136/bmj.328.7438.485-c

News

Netherlands to crack down on complementary medicine

Utrecht

The Netherlands is considering tougher laws on practitioners of complementary medicine after government health inspectors who were investigating the death from breast cancer in 2001 of the actress and comedienne Sylvia Millecam severely criticised her treatment.

The investigators found that alternative practitioners contradicted the diagnosis of breast cancer made by her doctors and offered her instead the prospect of a cure with "unfounded methods of treatment."

The report concluded that "various individual carers" had "offered such irresponsible care" that disciplinary action or criminal proceedings are likely. Their role prevented a cure or an extension of Ms Millecam's life, and she died from untreated breast cancer.

The Dutch Healthcare Inspectorate attacked the country's current "liberal regime" for not "sufficiently guaranteeing the protection of the citizen against malpractice by alternative carers" and called for measures to improve protection against "dangerous quackery."

Although relatives had lodged no complaint, the inspectorate launched an investigation in 2002 after persistent media reports saying that Ms Millecam had been a "desperate" cancer patient who "forfeited the chance of a cure."

The investigators' report found that between September 1999 and her death nearly two years later, when she was aged 45, Ms Millecam was treated by 28 different practitioners and institutions. Though mainstream care was available she exclusively chose alternative treatments.

Her general practitioner had first identified a lump of 1 cm radius in her breast. She was referred to a hospital radiology department, but the tests were inconclusive. She was referred to a surgeon, but instead she chose a doctor who practised alternative electro-acupuncture. She was assured that nothing was the matter.

The next May breast cancer was diagnosed, and surgery was recommended. Instead she saw a popular faith healer who said she did not have cancer and advised against chemotherapy. She then began regular visits for "healings." Over the next year she sought various cures, including "cell specific cancer treatment" at a Swiss clinic and "salt therapy," and visited a psychic healer. She was told on at least two occasions that she did not have cancer but a bacterial infection.

The inspectorate has reported six alternative practitioners to the public prosecution service. It has also confirmed that three doctors are being investigated for possible disciplinary action, including two of the six practitioners.

The inspectorate now wants the law changed to ensure greater supervision of alternative practitioners and that all such practitioners have to be registered. It also wants it made illegal for anyone other than a trained doctor to be allowed to make a medical diagnosis.

The Royal Dutch Medical Association supports the proposals. A spokeswoman said that regulations that applied to alternative healers in the 1997 law covering professional practice in individual health care had been relaxed. The Millecam case was just one of several that cast doubt on whether this relaxation was justified, she argued.

Sylvia Millecam died of breast cancer after having electroacupuncture, faith healing, salt therapy, and psychic healing Credit: ANP/PA

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Sade, R. M., Grande, D., Gorske, A. L., Campbell, E. G. (2007). A national survey of physician-industry relationships.. NEJM 357: 507-508 [Full text]  
• Sheldon, T. (2006). Dutch doctors suspended for use of complementary medicine. BMJ 332: 929-929 [Full text]  
• Dyer, O. (2005). WHO's attempts to eradicate polio are thwarted in Africa and Asia. BMJ 330: 1106-1106 [Full text]  
• Tuffs, A. (2004). Germany sets up quality control institute for health care. BMJ 329: 307-307 [Full text]  

Rapid Responses:

Read all Rapid Responses

Complementary vs Alternative Medicine

Wolfgang A Walter
bmj.com, 28 Feb 2004 [Full text]

To punish the innocent

Dr.Herbert H. Nehrlich
bmj.com, 28 Feb 2004 [Full text]

Other things involved

Henk A van Dam
bmj.com, 29 Feb 2004 [Full text]

A matter of choice

Alan B. Grosbach, M.D., et al.
bmj.com, 29 Feb 2004 [Full text]

Evidence Base

SM Pearce
bmj.com, 1 Mar 2004 [Full text]

Evidence circumstantial ?

Dr.Herbert H. Nehrlich
bmj.com, 2 Mar 2004 [Full text]

Medicine: Art or Science?

Garry Nieuwkamp
bmj.com, 19 Apr 2004 [Full text]