Arguing Against Colorado ND Licensure with the Wrong Reasons - Daily Camera's Editorial Board 2011-02-27

here, I cite some seriously disconcerting ignorance regarding the ethical position of professionalism as it relates to naturopathy [see 001., below; my musings are in bold]:

001. the Editorial Board of the Daily Camera [EBDC] states in "The Fight Over Naturopathy" [saved 2011-02-27]:

"on Tuesday, the state legislature's health committee will have a hearing on [...whether] naturopathic doctors [...should be] licensed in Colorado [...]";

Again.  Notice the desire is to be titled "doctor" as in 'diagnosing and treating disease' also known as MEDICINE, one of the classical professions.

"against licensure are some physicians [...] and the other naturopaths [...Daily Camera's editorial board sees ] a turf war [...] this is not a patient safety issue [...]";

I completely disagree.  What do you know, EBDC?  [Not much, it seems]. I am neither a physician nor a practitioner of naturopathy / sCAM.  I criticize naturopathy NOT based on market threat [I have none], but instead based on their claims as they relate to science, reason, and skepticism.  I did go to one of these ND 'residence' schools, so I've some inside knowledge.  A turf war insinuates an equality of claims / status when it comes to what is being argued over COMMERCIALLY, like two citizens of equal status fighting over grazing or farming rights.  Modern medical knowledge compared to naturopathic knowledge is not such an equality.  In fact, naturopathic knowledge is quite bizarre / irrational, from the get-go.  For instance, naturopathy claims that that which is science is the same thing as that which is not science [at an institutional level], and that it is appropriate to engage in commerce under such a false position wherein the science-exterior is falsely claimed as science [see OBNM]. That is scientifically wrong and ethically heinous.  That IS an issue of patient safety, since science is the best way we have of determining safety and efficacy.  Science gets thrown out the window in naturopathyland, but not so much that it isn't still used for marketing purposes.  Like creationism in the high school biology classroom, licensing naturopaths so they can indiscriminately label nonscience science [including their sectarian views which have been science-ejected for more than 100 years, actually, and sometimes dangerous and most-often-times ineffective treatments safe and effective; how can one know, in the naturopathic knowledge muddle?] is an attempt to gain science-legitimacy for that which isn't by political means instead of through the apparatus of modern science publication [via experimentation and peer-review].  Worse below.

"Kelly Parcell [...] vice president of the Colorado Association of Naturopathic Doctors, said the bill is important to protect patients. And we're all for patient safety [...]";

I don't see how consumers are protected when, inevitably, licensing naturopathy leads to licensed falsehood.  E.g., Oregon's '.gov' OBNM link above shows how NDs / NMDs label the hugely science-ejected as able to survive scientific scrutiny.  It's nuts.  As an independent board, complaints about them are referred to them.  When I've complained, they've humbly seen no problems with themselves.  Perhaps a naturopathic treatment like homeopathy -- which is an empty remedy -- isn't a direct harm, but the mere fact that the patient is being misled into the belief that the sugar pill they're getting is active and "science-based" [when it is actually science-ejected, and they're paying for it] is a kind of harm.  The patient has been financially harmed and deceived, and the relationship of trust between professional and client has been degraded to that of an self-interested buyer on a used car lot owned by a self-interested salesman.  More below.

"if people want to seek the services of a naturopathic practitioner, they are free to do so in Colorado [...] it's buyer beware -- it's up to the patients to do their due diligence on the person's practice and education [...] going to a doctor, going to a naturopath, or choosing to self-diagnose some illness on WebMD are consumer choices. All of that is up to patients, now and in the future";

So, I pick my jaw up off the floor.  It IS NOT a matter of buyer beware / commerce, EBDC.   You are COMPLETELY WRONG here.  On a used car lot, it is buyer beware.  The Latin phrase "caveat emptor" entails that.  But, in engaging with someone posing medical diagnostic and treatment knowledge, we are no longer in that 50-50 area of commerce where two self-interested parties try to make a deal.  The used car salesman is trying to get the most they can, the used car buyer is trying to get the most they can, and each does their best toward that end within legal boundaries.  Each is looking out for their-self FIRST.  But, that is ONLY IN commerce.  Professionalism is held to a higher ethical standard, particularly physicianship with its so VULNERABLE clients, which is what NDs claim to embody [I'd argue metaphysicianship!  As in metaphysical nonsense].  With professionalism, the clients' needs are placed FIRST ALWAYS.  The Latin for that is "credat emptor", let the buyer have faith -- not religious faith, but confidence of a FIDUCIARY nature -- that in their vulnerability yet, that professional be it traditionally ministry, law or medicine, would be held to a HIGHER ethical standard than just a used car lot type situation.  So, it is not buyer beware for the professions AT ALL, and it cannot be so for naturopathy.  That would be quite a bit of dangerous charity.  It is also not 'science is anything' AT ALL for naturopathy, though naturopathy embodies such a charity-resultant knowledge position as well.  What EBDC would have us do is lower standards to such an extent that medicine would merely be a relationship of commerce instead of professionalism.  That WON'T happen.  What could happen with Colorado licensure of NDs, in part: NDs would get their own board to police themselves claiming professionalism status [professions are self-policing] and science-based status, complaints would be handled by NDs about NDs' claims and methods, since naturopathy is essentially irrational and so much is science-ejected labeled science anyway, there are no standards of any consequence to uphold and they'd find nothing wrong.  Something is what it isn't in naturopathyland; science is nonscience, professionalism is falsehood [merely commerce too], wrong is right.  Nice MUDDLED arrangement.  It benefits nobody but naturopathy.

"doing it through legislation and regulation is not the way to go";

I agree that naturopathy shouldn't be licensed, but not for EBDC's dense reasons.  I actually believe, knowing what I know, that naturopathy should be prosecuted because they don't even meet the standards of commerce -- never mind the higher standards of professionalism.

I'll bet what I've said above is over EBDC's heads anyway, but to summarize: licensing naturopathy leads to licensed falsehood.  It does great harm to the public's understanding of what is legitimately science [and rational discourse] and it destroys the HUGE difference in relationship between commerce and the higher standard of professionalism / fiduciary duty.

 

Naturopathy would have it both ways: science that isn't really but labeled anyway, professionalism that isn't really but labeled anyway.  That's pseudoscience and pseudoprofessionalism -- wisely marketed.

Shallowly, probably few care until the rubber hits the road.  When cornered, NDs presumably would fall back on 'but they let us be licensed, and we are who we always have been.'

After all, "naturopathy blends."  And mislabels.  And is an interesting study in junk thought.

Undermining Professionalism - 'Caveat Emptor' per Naturopathy - Perle et al. & UW, UB & ISBN 1741140544:

here, I cite Perle et al. & U.W.S.M. as regards the 'preponderant ethical rigor' required of a modern healthcare professional of any kind [see 001., below]; the University of Bridgeport's labeling of naturopathy as 'nonsectarian science' [see 002.a., below] and 'naturopathic luminaries' labeling of naturopathy as 'professional' [see 002.b., below]; and a warning -- per caveat emptor!!! -- something that shouldn't have to be said about something claiming 'professionalism' [see 003., below]:

001. Perle et al. & University of Washington School of Medicine -- on 'credat vs. caveat emptor':

001.a. apparent 'chiropractic reformers' Murphy, Schneider, Seaman, Perle and Nelson state in "How Can Chiropractic Become a Respected Mainstream Profession? The Example of Podiatry" {Chiropractic & Osteopathy; 2008, 16:10}:

"the professions, which classically included medicine, law and the ministry, are vocations whose members 'profess' to have knowledge that the laity do not comprehend. Given the asymmetry of knowledge between professionals and the laity, society has granted to the professions a certain degree of autonomous control over themselves. However, this social contract demands that each profession, and each professional, place the well-being of society and the patient, client or parishioner ahead of the profession and professional [per fiduciary duty {see 001.b., below}]. Lay persons put their faith in the professional following the dictum credat emptor (let the buyer have faith) rather than [the dictum] caveat emptor (let the buyer beware)[per typical commerce]. This social contract imparts great freedom on all professions, but with this freedom comes great responsibility. When an individual consults a member of any of the medical professions, it is reasonably [!!!] expected that the advice and treatment that he or she receives is based in science, not metaphysics or pseudoscience ['ye olde sectarian medicine']. In addition, it is reasonably expected that the services he or she receives are being provided for the primary purpose of benefiting the patient, and not for any other reason. The financial benefit to the professional is secondary, and results from the degree of clinical benefit received by the patient. Patients place their faith in the professional, and trust that they will not be subject to fraud, abuse or quackery ['ye olde sectarian medicine']. This is the social contract as it applies to chiropractic physicians [& I would add 'all who invoke the status of a healthcare professional']."

Note 01: 'trustworthy'[literally], client-centeredness, and 'overall societal well-being' are hallmarks of 'the professions' as expressed in the dictum "credat emptor." In terms of a healthcare profession, the 'knowledge and technique set' is expected to be scientific / competent as opposed to pseudoscientific / fraudulent, physicalistic / naturalistic / actual as opposed to metaphysical / supernatural / woo-woo quackery abuse.

Note 02: I list Perle [perle@bridgeport.edu; academic homepage] in terms of authorship in the title of this blog-post for no other reason than because he's a former instructor I had [for a research methods course] at the University of Bridgeport while pursuing an ND there [a fraudulently categorized degree, GALORE -- to this day, completely at odds with the above passage!!!]. Murphy [rispine@aol.com] is actually this article's lead contact.

001.b. the University of Washington School of Medicine states in "Professionalism":

"because medicine is a profession and physicians are professionals, it is important to have a clear understanding of what 'professionalism' means [...] the words 'profession' and 'professional' come from the Latin word 'professio,'which means a public declaration with the force of a promise [...] the line between a business and a profession is not entirely clear [...] one crucial difference distinguishes them: professionals have a fiduciary duty toward those they serve. This means that professionals have a particularly stringent duty to assure that their decisions and actions serve the welfare of their patients or clients, even at some cost to themselves. Professions have codes of ethics which specify the obligations arising from this fiduciary duty [...] A Physician Charter. Medical Professionalism in the New Millennium was issued jointly by the The American Board of Internal Medicine, the American College of Physicians and the European Federation of Internal Medicine in 2002. Subsequently, 90 professional associations, including most of the specialty and subspecialty groups in American medicine have endorsed the Charter. The fundamental principles of professionalism are stated as (1) the primacy of patient welfare; (2) patient autonomy; (3) social justice. Professional responsibilities that follow from these principles are commitment to competence, to honesty with patients, to confidentiality, to appropriate relationship with patients, to improving quality of care, to improving access to care, to a just distribution of finite resource, to scientific knowledge, to maintaining trust by managing conflicts of interests and to professional responsibilities."

Note: professionalism in medicine includes the principle that the patient comes first per fiduciary duty, that patients and the public are dealt with honestly [disclosure / transparency], and an overarching commitment to scientific knowledge [modern epistemic rigor].

002. naturopathy's self-labeling:

002.a. per 'of the professions' 'nonsectarian health science' by the University of Bridgeport:

002.a1. U.B.'s 'professional science' labeling, in "College of Naturopathic Medicine":

"the University of Bridgeport College of Naturopathic Medicine is a non-profit, co-educational professional institution which grants the Doctor of Naturopathic Medicine (N.D.) degree to graduates who successfully complete four academic years of study including clinical training [...] naturopathic medicine is a distinct system of primary health care -- an art, science and practice of preventing, diagnosing and treating conditions of the human mind and body."

Note: naturopathy is labeled a profession, a science, and nowhere in the description is the supernatural mentioned.

002.a2. in "UB Spotlight: Health Sciences Programs":

"the University's professionally accredited health sciences programs [...include] the College of Naturopathic Medicine [...per] Naturopathic Medicine (N.D.) [...] the members of the faculty include skilled instructors with backgrounds in the biomedical and clinical sciences."

Note: the label "professional" / 'of the professions', and the label of "science" upon naturopathy by UB.

002.a3. UB nonsectarian label:

U.B. also is chartered & self-labeled "nonsectarian," and society was assured of this in 1995 by its President, per the New York Times, two years before the entry of the first students into U.B.'s naturopathy college & three years before my own entry.

002.b. per 'of the professions' by NDs Stephen P. Myers, Assunta Hunter, Pamela Snider, & Jared L. Zeff in "An Introduction to Complementary Medicine" {edited by naturopath Robson} (ISBN 1741140544; 2004):

"naturopathic medicine [...is a] profession [p.048...] the philosophy-based approach defining the profession [vitalism, et al....] the profession's ability to consistently voice its philosophy [...] the profession's unique identity [...] in 1986 the American Association of Naturopathic Physicians (AANP) [was established as] a newly revived professional association [...and] commissioned Dr. Pamela Snider and Dr. Jared Zeff to create a unifying definition of naturopathic medicine [...via] input from the entire US profession [...] the committee found a single element of agreement among the profession upon which it built its process. This element was the general agreement that the profession was unified by a philosophy [vitalism, et al....] the committee sifted through input from the profession cataloging six principles upon which the profession generally agreed [...] these six principles were placed before the House of Delegates of the AANP at its annual conference in September 1989 at Rippling River, Oregon, which unanimously approved them, reconfirming and articulating in modern terms its core principles as a professional consensus [p.049...this] profession [p.052...our] profession [p.059...our] profession [p.060...] one significant interprofessional challenge [etc....] another interprofessional challenge [etc....] interprofessional communication [etc....] the professionalization of naturopathic clinicians [etc. p.062...the] rapid professional evolution within naturopathic medicine [etc....] naturopathic and orthodox health [p.065] professionals [etc....] many challenges will need to be met by the profession [etc....] those within the [naturopathic] profession generally see the future as positive and the potential of their medicine and profession as immense [p.066]."

Note: their labeling of naturopathy as medical, philosophy-based [principally, a sectarian belief-set centered upon the science-ejected concept of vitalism {a 'purposeful life spirit bioagency' sectarian belief / article of faith} supernaturalism, and overarchingly 'of the professions.'

003. naturopathy's explicit untruthfulness:

in sum, pseudoscientific, metaphysical, supernatural, vitalistic / science-ejected, sectarian 'dogma & quackery' are being falsely postured as scientific and nonsectarian. Therein, naturopathy is not a trustworthy domain.

So, my warning as regards this OBVIOUS pseudoprofession known as naturopathic medicine:

"danger Will Robinson, unethical sectarian pseudoscience!"

Caveat emptor!!!

Centered around and obligated toward 'the science-ejected sectarian' [more often expressed in a coded / occultic manner] but claiming 'health professions scientific status', naturopathy severely violates many professional ethical rigors per healthcare, medicine, and education.