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Gästkrönika

The Swedish Quackery Law of 1960

Publicerad: 1 Februari 2014, 20:13

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Homeopat Gunnar Jansson har nyss sänt brev till Unicef, Diskrimineringsombudsmannen och  Socialstyrelsen där han frågar varför barn under åtta år inte kan få homeopatisk behandling i Sverige. Det stämmer inte helt. Barn upp till sju års ålder får visserligen inte behandlas av icke-legitimerade vårdgivare, men de kan i princip få homeopatisk behandling av en legitimerad sjuksköterska/läkare/kiropraktor utan att hen bryter mot kvacksalverilagen.

Holland har en ärevördig förening mot kvacksalveri, Vereniging tegen de Kwakzalverij, och jag hade förra året nöjet att vara inbjuden till Amsterdam för att hålla ett föredrag, på engelska, om hur svensk lag skyddar barnen mot kvacksalveri:

In Sweden there is since more than 50 years a law commonly called the Quackery law. Among other things this legislation define which health services can only be delivered by authorized medical personnel. The draft bill proposing the law was called Kvacksalveriutredningen, ”The Quackery Paper”, and was put forward already in 1956.

The essence of the law is that only authorized medical personnel may diagnose or treat notifiable contagious diseases (serious infections), cancer, diabetes, epilepsy, complications of pregnancy/childbirth and children under a certain age. The proposal in the draft bill was that children under the age of one year should not be exposed to quackery. At the time the most common providers of alternative health services were Sweden's 300 homeopaths. Chiropractors and traditional healers then numbered less than 50 each.

The age limit was the subject of political discussion. The draft bill proposed that only infants should be protected, while the Medical Board (Medicinalstyrelsen) argued for an 18 year limit. The parliament settled by drawing the line at 8 years. By that age the child would receive health care from physicians working in the school health care system,  providing a safety net. The new Patient Safety Law of 2010 has incorporated the principles of the old Quackery Law, so it is still in effect. But there has recently been some political pressure to change it.

Among others the Society of Psychologists and some members of the parliament who are physicians have recently criticized the fact that the Quackery Law does not protect patients with mental health problems, and the same could be said of many other serious medical conditions not listed in the law. It does not seem logical to protect persons with diabetes, but not those with other endocrine diseases. And why is a person with epilepsy protected, but not a person with Parkinson, MS, ALS, stroke or dementia?

On the other hand there is a lobby group from proponents of so-called alternative medicine calling for the age limit in the Quackery Law to be abolished. The lobby group call itself ”Hela Barn” which can translate both as ”healing children” and ”whole children”. Hela Barn has managed to petition the UN Committee on the Rights of the Child (CRC), and in 2009 the Swedish government received a letter from the CRC noting that access to complementary and alternative medicine (CAM) is recognized in Europe and the rest of the world.

The Committee recommends that Sweden consider reviewing and amending existing legislation to ensure that all children, without distinction of age, have access to complementary and alternative medical (CAM) examination, treatment and care and can enjoy their right to the highest attainable standard of health.”

Our government stands fast and has no intention of changing the 8 year age limit in the law. Still some young children in Sweden may be exposed to quackery from within the normal medical system because the Quackery Law does not prevent licensed medical personnel from practicing alternative medicine.

Chiropractors and naprapaths can be licensed in Sweden as medical personnel, while osteopaths and reflexologists can't. Some chiropractors claim to be able to treat pediatric conditions like infantile colic, bedwetting and recurrent ear infections with  their spinal manipulation.

Few doctors in Sweden use alternative medicine. The anthroposophic hospital in Järna uses homeopathic preparations, but treat few children. A bigger problem is the anthroposophic belief that it is spiritually beneficial for young children to get measles and they should therefore not be vaccinated. In the last few years there has been small outbreaks of measles and rubella in the anthroposophic community.

Acupuncture was too hastily accepted into mainstream medicine, in my opinion, and is used by physiotherapists and some nurses and doctors. Acupuncture in the thumb grip is proposed in Sweden as a treatment for infantile colic, and might have a placebo effect greater than more conventional treatments (most of which also relies on the placebo effect).

It is seldom that quacks are brought to trial, but this happened in 2010 when a self proclaimed Ayurvedic doctor was convicted for ten cases of fraud and five cases of sexual molestation (oil massage of the women's breasts and genitals). The sentence was three and a half year in prison, longer than if he had been tried by the Quackery Law, as the maximum penalty of unlawful quackery is maximum one year in prison.

The Ayurvedic doctor was not charged with the serious crime of treating a woman suffering from cancer with ”medication” consisting of cabbage, basil and mussel oil. The treatment cost her over €5000 and the woman later died from her tumour.

I do not think that Swedish children are at any great risk from dangerous quack treatments. But there is a risk that a few will receive substandard health care because of quackery. For example not being given vitamin K at birth, not being fully vaccinated, not given the best medication for eczema, allergy or asthma, being put on unnecessary diets or being socially isolated after a quack diagnosis of electrohypersensitivity.

MATS REIMER

Det här är opinionsmaterial

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