Medicandus

Medicandus

Would better regulation of CAM practitioners have saved Penelope Dingle?

The tragic case of Penelope Dingle’s death from a potentially treatable cancer was the subject of a moving ABC Australian Story. Following a coronial inquest, the case continues to make headlines with Penelope’s sister Toni Brown suing homeopath Francine Scrayen who allegedly advised against pursuing conventional treatment in favour of alternative therapies.

The merits of these allegations will be debated at length in other places, but I want to focus on the fairly obvious question I have posed above. Registration by the Australian Health Practitioner Regulation Agency (AHPRA) has been debated for naturopaths, homeopaths and others of their ilk. Proponents argue that standards of training and practice will be improved by statutory regulation. Opponents argue that AHPRA regulation would give consumers false confidence in the efficacy of CAM modalities.

According to the Coroner’s report:

While I accept the evidence of Sylvia Neubacher to the effect that making such a representation went beyond the Australian Homeopathic Association Code of Conduct and that the Association has attempted to provide accountable structures to ensure that homeopathic practitioners are qualified and have medical and professional standards which would provide a safeguard to consumers, I have serious reservations about any efforts to register or otherwise legitimise homeopathy or other similar alternative forms of medicine. While I do not agree with the proposition that such alternative medical regimes should be outlawed, unless and until their supporters can provide appropriate and sufficient science base, any apparent legitimisation of these regimes could provide mixed messages for vulnerable and often desperate cancer suffers.

I could hardly agree more. This point of view is exactly consistent with common sense and ethical obligations. Consumer choice is only a valid argument when both alternatives are viable. Providers of health care have more responsibility not to mislead their customers than call centre workers.

It seems sadly true that Penelope Dingle would not have been saved by seeing a registered CAM practitioner, as the Coroner concluded that it was ultimately her own choices, made in the framework of “misinformation and poor science” that lead to her needlessly untimely and agonising passing. Living in an environment of uncritical acceptance of ersatz medical treatments and antagonism towards conventional medicine was the real reason that she made the choices she did. No amount of sanctioning individual practitioners will change that, or prevent it happening to others.

If we are to learn anything from this whole pitiable saga, perhaps it should be that we need to create a public discourse where desperate and scared patients are not given false choices. Banning therapies is usually an ineffective last resort. Far better to educate the average punter to avoid outright scams and for official bodies to avoid lending the illusion of gravitas to absurd therapies. For better or worse, Australians trust their public institutions. Government bodies like universities and regulatory agencies must be worthy of this trust, and effectively protect the public from misinformation and the susceptibility of some well-intentioned practitioners to fall for traps that more scientific souls have learned the hard way to avoid. There is no national professional register of Nigerian email scammers or psychic hotline providers. Why would we need one for homeopaths?