Marco Jurídico-Legal de la Homeopatía en México: análisis histórico y conceptual de los artículos 28 y 50 del reglamento de insumos para la salud / Juridical-Legal Framework of Homeopathy in Mexico: historical and conceptual analysis of articles 28 and 50 of the regulation of health supplies

El interés por diseñar un marco jurídico específico para la práctica de la Homeopatía ha generado diversos criterios alrededor del mundo, debido a la nomenclatura establecida por la Organización Mundial de la Salud (OMS). Este organismo, de una visión sociológica y antropológica, incluye a la Homeopatía en el concepto de medicina alternativa y/o complementaria (MAC o CAM, por sus siglas en inglés), pero, al mismo tiempo, señala que cada país es autónomo para reglamentar y formular políticas acordes a sus circunstancias. El caso de México merece una mención especial, pues a finales del siglo XIX formalizó la institucionalización, profesionalización e inclusión de la Homeopatía en el Sistema Nacional de Salud como parte de la medicina. A pesar de ello, la existencia del término "homeópata" en la legislación sanitaria ha generado un debate por más de dos décadas entre médicos homeópatas y homeópatas no médicos que buscan reglamentar su práctica mediante legislaciones hechas a modo. Dentro de este contexto, se analiza el proceso histórico y conceptual del término "homeópata" en la legislación sanitaria mexicana mediante el estudio de leyes y reglamentos desde su introducción, en 1850, permitiendo afirmar que dicho término reconoce a los médicos homeópatas formados en escuelas y facultades de medicina y no a homeópatas no médicos.

The interest in designing a specific legal framework for the practice of homeopathy has generated diverse criteria around the world; due to the nomenclature established by the World Health Organization (WHO). The WHO, from a sociological and anthropological perspective includes homeopathy in the concept of Alternative and / or Complementary Medicine (MAC or CAM, for its acronym in English); however, at the same time it indicates that each country has the autonomy to regulate and formulate policies according to its circumstances. The case of Mexico deserves a special mention, since at the end of the 19th century it formalized the institutionalization, professionalization and inclusion of homeopathy in the National Health System as a part of formal medicine. Despite this, the term "Homeopath" in health legislation has generated a debate for more than two decades between homeopathic doctors and non-medical homeopaths who seek to regulate their practice through legislation made for this manner. Within this context, the historical and conceptual process of the term "Homeopath" in Mexican health legislation is analyzed through the study of the laws and regulations since its introduction in 1850, which confirms that said term recognizes Homeopathic Doctors trained in schools and colleges of medicine and not non-medical homeopaths.

George Deacon and the circulation of homeopathic therapies in Lima (1880-1915).

Homeopathy arrived from the United States to Peruvian soil in the last decades of the nineteenth century, broadening the repertoire of existing medical knowledge, which included an emerging medical profession, Chinese herbalists, and indigenous practitioners. This article examines the circulation and use of homeopathic therapies and medicines in Lima from the time when the American homeopath George Deacon initiated his practice, in the 1880s, until his death, in 1915. Although homeopathy was not the most widely used medical therapy in the country, it nevertheless posed a threat to professional medicine and the School of Medicine's desired monopoly of the field of medicine.

Breaking the boundaries of professional regulation: medical licensing, foreign influence, and the consolidation of homeopathy in Mexico.

As doctors sought state support to regulate professional training and practice after Independence, Mexicans also developed different attitudes toward foreign ideas, influences, and professionals. Leveraging the allure of the foreign among Mexicans, homeopaths strategically used work, products, and organizations from abroad to establish their practices and fight changing professional policies in the country that threatened homeopathic institutions. Homeopaths inhabited the blurry and shifting boundary between professional and lay medical practice during the early Republican period, the Porfiriato, and the post-revolutionary era, and used the ambivalent feelings about medical licensing, and foreign influence in Mexican society to consolidate their position.

[Defending entitlement: struggles and fate of the practice of homeopathy in Colombia (1905-1950)]. / Defensa de los derechos adquiridos: luchas y albures del ejercicio de la homeopatía en Colombia (1905-1950).

This article analyzes the practice and professional status of Colombian homeopaths in the twentieth century, based on applications for licenses in the "Teguas" series in the Archivo General de la Nación. Within the historical context of the practice of medicine in Colombia, it studies homeopathic practice within the framework of the debate between licensed and permitted medicine. In that context, the field of homeopathy was subordinate to university medicine and homeopaths were a group of practitioners who were neither homogeneous nor organized, but characterized by their shared struggle to become "entitled" to practice, and their advocacy of professional status through constant litigation against official reprimands.

El artículo analiza la práctica y el estatuto profesional de los homeópatas colombianos en el siglo XX, según las solicitudes de licencia de la serie "Teguas" del Archivo General de la Nación. Desde el contexto histórico del ejercicio de la medicina en Colombia, se estudia la práctica homeopática en su inserción en el debate entre medicina diplomada y medicina permitida. Ahí aparece la homeopatía como un campo subordinado a la medicina universitaria y los homeópatas como conjunto de practicantes no homogéneo ni organizado, pero caracterizado por compartir la lucha por el "derecho adquirido" a ejercer y por la defensa de un estatuto profesional mediante la judicialización constante de la reprobación oficial.

Defensa de los derechos adquiridos: luchas y albures del ejercicio de la homeopatía en Colombia (1905-1950) / Defending entitlement: struggles and fate of the practice of homeopathy in Colombia (1905-1950)

Resumen El artículo analiza la práctica y el estatuto profesional de los homeópatas colombianos en el siglo XX, según las solicitudes de licencia de la serie "Teguas" del Archivo General de la Nación. Desde el contexto histórico del ejercicio de la medicina en Colombia, se estudia la práctica homeopática en su inserción en el debate entre medicina diplomada y medicina permitida. Ahí aparece la homeopatía como un campo subordinado a la medicina universitaria y los homeópatas como conjunto de practicantes no homogéneo ni organizado, pero caracterizado por compartir la lucha por el "derecho adquirido" a ejercer y por la defensa de un estatuto profesional mediante la judicialización constante de la reprobación oficial.

Abstract This article analyzes the practice and professional status of Colombian homeopaths in the twentieth century, based on applications for licenses in the "Teguas" series in the Archivo General de la Nación. Within the historical context of the practice of medicine in Colombia, it studies homeopathic practice within the framework of the debate between licensed and permitted medicine. In that context, the field of homeopathy was subordinate to university medicine and homeopaths were a group of practitioners who were neither homogeneous nor organized, but characterized by their shared struggle to become "entitled" to practice, and their advocacy of professional status through constant litigation against official reprimands.

George Deacon and the circulation of homeopathic therapies in Lima (1880-1915) / George Deacon e a circulação de tratamentos homeopáticos em Lima (1880-1915)

Abstract Homeopathy arrived from the United States to Peruvian soil in the last decades of the nineteenth century, broadening the repertoire of existing medical knowledge, which included an emerging medical profession, Chinese herbalists, and indigenous practitioners. This article examines the circulation and use of homeopathic therapies and medicines in Lima from the time when the American homeopath George Deacon initiated his practice, in the 1880s, until his death, in 1915. Although homeopathy was not the most widely used medical therapy in the country, it nevertheless posed a threat to professional medicine and the School of Medicine's desired monopoly of the field of medicine.

Resumo A homeopatia originária dos EUA adentrou solo peruano nas últimas décadas do século XIX, ampliando o repertório de conhecimento médico existente até então, o qual incluía uma profissão médica em ascensão, herbolários chineses e médicos locais. Este artigo analisa a circulação e o uso de tratamentos e medicamentos homeopáticos em Lima desde o período em que o homeopata norte-americano George Deacon iniciou sua prática, nos anos 1880, até sua morte, em 1915. Embora a homeopatia não fosse o tratamento médico mais disseminada no país, ela representou uma ameaça à medicina profissional e ao monopólio do campo da medicina almejado pela escola tradicional.

Breaking the boundaries of professional regulation: medical licensing, foreign influence, and the consolidation of homeopathy in Mexico / Rompendo as barreiras da regulamentação profissional: licenciamento médico, influência estrangeira e consolidação da homeopatia no México

Abstract As doctors sought state support to regulate professional training and practice after Independence, Mexicans also developed different attitudes toward foreign ideas, influences, and professionals. Leveraging the allure of the foreign among Mexicans, homeopaths strategically used work, products, and organizations from abroad to establish their practices and fight changing professional policies in the country that threatened homeopathic institutions. Homeopaths inhabited the blurry and shifting boundary between professional and lay medical practice during the early Republican period, the Porfiriato, and the post-revolutionary era, and used the ambivalent feelings about medical licensing, and foreign influence in Mexican society to consolidate their position.

Resumo Após a independência do país, enquanto os médicos buscavam apoio do Estado para regulamentar o treinamento e a prática profissionais, os mexicanos desenvolveram atitudes diferentes em relação a ideias, influências e profissionais estrangeiros. Aproveitando o encanto dos mexicanos com o estrangeiro, os homeopatas usaram estrategicamente o trabalho, os produtos e as organizações de fora do país para implantar suas práticas e combater as políticas que ameaçavam as instituições ligadas à homeopatia. Os homeopatas ocuparam a barreira nebulosa entre as práticas médicas profissional e leiga no início do período republicano, no Porfiriato e na era pós-revolucionária, usando sentimentos ambivalentes sobre licenciamento médico e influência estrangeira para consolidar sua posição.

Should Anthroposophic Medicinal Products Be Regulated in Europe?

European Commission's reports suggest that the European Union should address the status of anthroposophic products, i.e. products that are developed, manufactured and prescribed in accordance with the holistic approach on which anthroposophic medicine is based. Anthroposophic products cannot be placed as such on the European market because they cannot meet the marketing authorisation or even registration requirements set out by European or national pharmaceutical law. Yet, the 95-year European tradition and good safety profile of anthroposophic products justify giving them an easier access to market. Such access can result from specific rules on anthroposophic products, but can be more efficiently achieved by encouraging the Member States to better apply the existing rules on marketing authorisation procedures or on registration of homeopathic and traditional herbal medicinal products, or by including anthroposophic substances, manufacturing methods or uses in monographs.

THE MEDICO-SCIENTIFIC MARGINALISATION OF HOMEOPATHY: INTERNATIONAL LEGAL AND REGULATORY DEVELOPMENTS.

The 2010 report of the United Kingdom Science and Technology Committee of the House of Commons and the 2015 report of the Australian National Health and Medical Research Council have overtaken in significance the uncritical Swiss report of 2012 and have gone a long way to changing the environment of tolerance toward proselytising claims of efficacy in respect of homeopathy. The inquiry being undertaken in the United States by the Food and Drug Administration during 2015 may accelerate this trend. An outcome of the reports and inquiries has been a series of decisions from advertising regulators and by courts rejecting medically unjustifiable claims in respect of the efficacy of homeopathy. Class actions have also been initiated in North America against manufacturers of homeopathic products. The changing legal and regulatory environment is generating an increasingly scientifically marginalised existence for homeopathy. That new environment is starting to provide effective inhibition of assertions on behalf of homeopathy and other health modalities whose claims to therapeutic efficacy cannot be justified by reference to the principles of evidence-based health care. This has the potential to reduce the financial support that is provided by insurers and governments toward homeopathy and to result in serious liability exposure for practitioners, manufacturers and those who purvey homeopathic products, potentially including pharmacists. In addition, it may give a fillip to a form of regulation of homeopaths if law reform to regulate unregistered health practitioners gathers momentum, as is taking place in Australia.

Ethical and legal issues in cross-system practice in India: Past, present and future.

Recent changes in policies allowing practitioners of Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) to integrate into the mainstream of healthcare and also allowing practitioners of Ayurveda and Homoeopathy to perform medical termination of pregnancy (MTP) under the proposed amendment to the MTP bill have brought crosssystem practice into the limelight. We evaluate cross-system practice from its legal and ethical perspectives. Across judgments, the judiciary has held that cross-system practice is a form of medical negligence; however, it is permitted only in those states where the concerned governments have authorized it by a general or special order. Further, though a state government may authorize an alternative medicine doctor to prescribe allopathic medicines (or vice versa), it does not condone the prescription of wrong medicines or wrong diagnosis. Courts have also stated that prescribing allopathic medicines and misrepresenting these as traditional medicines is an unfair trade practice and not explaining the side-effects of a prescribed allopathic medicine amounts to medical negligence. Finally, the Supreme Court has cautioned that employing traditional medical practitioners who do not possess the required skill and competence to give allopathic treatment in hospitals and to let an emergency patient be treated by them is gross negligence. In the event of an unwanted outcome, the responsibility is completely on the hospital authorities. Therefore, there is an urgent need to abolish cross-system practice, invest in healthcare, and bring radical changes in health legislations to make right to healthcare a reality.