The transition toward the new governing structure has been slowed by fierce debate. Proponents of naturopathic medicine worry the new legislation will limit the scope of the profession by outlining a schedule of permissible practices. On the other hand, opponents argue the new structure increases the role of naturopaths to the point of crossing into the practice area of physicians and registered nurses, posing serious risks to public safety.
Background
More than 1200 naturopaths are currently registered in Ontario. They blend science with traditional and natural therapies to stimulate natural healing processes. To be registered, naturopaths must graduate from a recognized naturopathic education program and pass provincial and North American standardized exams. Since 1925, they have been regulated under the Drugless Practitioners Act. Under this scheme, they cannot perform surgery, midwifery or prescribe or administer drugs or anesthetics. However, this structure has allowed naturopaths to operate in a legal grey zone.
The move toward self-regulation of naturopaths in Ontario has paralleled the growing popularity of alternative medicine in Canada, as well as the self-regulation of naturopaths in other provinces. Naturopaths are currently regulated in BC, Alberta, Saskatchewan, Manitoba and Nova Scotia.
What’s new?
Under the Naturopathy Act, naturopaths will only be able to perform controlled acts listed in the RHPA. This includes taking blood samples, giving injections and giving naturopathic diagnoses. However, draft regulations created by the College have suggested authorized acts could include high-risk practices that opponents deem exceed the scope of naturopathy. The new structure does not change the fact that visits to naturopaths are not covered by provincial health insurance.
Reaction
For the College, the new regulations restrict how naturopaths have traditionally exercised their role. The regulations in Ontario are also stricter than those in other jurisdictions, such as BC and California. In those places, naturopaths can use X-ray machines, provide high blood pressure diagnoses and perform minor surgery. These activities would be prohibited under Ontario’s new regime.
Yet opponents would like the new regime to significantly narrow the scope of naturopathy. Registered Nurses and the Ontario Medical Association have voiced safety concerns over allowing naturopaths to order lab testing for conditions like HIV/AIDS and hepatitis. In addition, they warn of the risks of allowing naturopaths to administer substances for which they lack training, such as potassium chloride, lithium, and epinephrine. In a public submission, The Ontario Medical Association has also stated that the proposed regulations problematically grant naturopaths the ability to practice medicine in some circumstances instead of naturopathic medicine. For instance, naturopaths may order lab testing for serious medical conditions or organ failure.
Some opponents even challenge the regulation of naturopaths entirely. They argue that bringing naturopaths under the RHPA will assign credibility to a profession whose practices are not underpinned by evidence-based medicine. These critics point out that naturopathy follows a pre-scientific static belief system that fails to evolve alongside changes in modern science.
At a time when a rising numbers of Canadians are seeking alternative health therapies and Canada is facing new health challenges related to its diverse ageing population, this debate is worthy of attention.
McGill Journal of Law and Health 