Bill 179: What can we do next?

By now, hopefully everyone who reads this blog reads also Skeptic North on a regular basis. If not, you should.  Because a) There is some really high-quality analysis and writing going on, b) I'm the editor, so if you show them some love, then by the transitive property, you also show me love, and c) you can learn all manner of important Skeptic issues in Canada.  Right now, one of the most urgent health issues in Canada is a political one.

Before you read this post, I suggest you read Scott's post about Bill 179, and then continue on to my own follow-up post.  In brief, Bill 179 is a bill put forth before the Ontario Legislature that would, by way of amending the Naturopathy Act, 2007, grant naturopaths the right to prescribe schedule 1 drugs (schedule 1 means anything that requires a prescription).  If you read this blog with any sort of regularity, I hardly need explain what a colossally blunderous and dangerous move this would be.

Proponents of the Bill have have framed this issue as a matter of freedom-of-choice:  Freedom for the consumer to have access to as many alternative healthcare modalities as possible, and freedom for the naturopaths to have access to the medicines that they need.

But lets be very clear:  
This is not about freedom of choice.  This is about using legislative tools to grant legitimacy to an alternative treatment that cannot stand up to the standards of science and evidence that conventional, (a.k.a. effective) medicine has to abide by.

Naturopathy can't prove its efficacy either scientifically or medically, so it's supporters try to convince the general populace and politicians by appealing to their better nature of fairness and freedom.  They've convinced huge swaths of the Ontario Legislature that patient safety and disease control matter less than the freedom to choose a medicine that doesn't work, and indeed may even harm someone.  They're convincing people that naturopaths, acupuncturists and homeopaths are primary health care providers, all on the power of freedom and placebo.

Now imagine this man prescribing your anti-inflammatories, psychotropics, or heart-medication.

Well, Skeptic North helped to get the word out, and many of our readers dutifully responded, and emailed Ontario Minister of Health and Long-Term Care, Deb Matthews and Premier Dalton McGuinty (The email link will also CC the leaders of the two opposition parties, Tim Hudak of the Progressive Conservatives, and Andrea Horwath of the NDP).  I only wish that the response from the political arena was as positive as the response from the skeptical community.

By now, some of you may have already received this email from the NDP:
Thank you for your email sharing your views on Bill 179, RX privileges for Naturopaths. Ontario's New Democrats support prescribing authority for Naturopathic Doctors (NDs). There has unfortunately been misinformation circulating regarding this new prescribing authority as well as the training, practice, and beliefs of the regulated health profession of Naturopathy.

New Democrats have supported prescribing authority for Naturopaths as it is necessary to maintain NDs current access to natural or botanical substances used in the course of their practice. New Democrats support
an evidence-based, regulatory system that places the safety of Ontarians first. Although Naturopaths have been granted the ability to prescribe, the substances that will be available to them will go through a lengthy
regulatory process and grant access only to substances that NDs have the appropriate training to prescribe.

Granting Naturopaths prescribing rights is a necessary measure for the Ontarians who choose to visit these health care providers. While New
Democrats respect the choice and diversity of opinions that Ontarians have regarding the practice of Naturopathy, we are confident that this expanded right is in the best interest of Ontarians who choose to visit a Naturopathic Doctor.

Thank you again for taking the time to write me.


Ezia Cervoni,
Leader's Correspondence Officer
On behalf of Andrea Horwath, MPP
Leader, Ontario's NDP

I've received several emails from Skeptic North readers advising me of their response, and yes, this is a form-letter.  This response tells me a few things:

1) The NDP is either ideologically aligned with the bill's amendments, or they have been swayed by the language of freedom over efficacy
2) The NDP is lazy, or,
3) They're getting enough responses that they're finding the volume a bit much to deal with. This means that the other parties are also getting the same emails and may be facing a similar traffic issue.

Now, whether or not you've not yet written your email, here are my tips (straight from a political skeptic!):

1) If you have written, and gotten the NDP's form-letter response, then respond to their arguments, point-by point.  Include links that demonstrate the poor track record of naturopathy, and the loose academic standards of naturopathic colleges.  Make sure you CC all the original recipients, so that everyone can see the form letter response, and everyone knows who else is reading the same thing.

2) If you have not written, write now.  We're running out of time.  Use the NDP's form letter to preemptively counter the disingenuous  and faulty argument of freedom, and instead stress efficacy, patient safety and the record of harm that naturopathy has.  Include links, but don't overwhelm them.  A link to Scott's initial piece should suffice, but another one wouldn't hurt either (something from Science Based Medicine perhaps?).

3) Be civil, polite and, yes, political.

4) Whether you're writing for the first or second time, when you close off your email, make sure you include where you are from, including your riding information particular (if applicable).  Make sure you also include any credentials you may have, especially if they're in media, academics, government, law, education, or health care.  If these categories don't apply to you, that's fine:  We need to let them know that this is an issue at both the grassroots and professional levels.  "Concerned voter" means just as much as "Professor of Pharmacology" to a politician.

5) You don't have to be an Ontario (or even Canadian) citizen to write and express your concern.  If you're a heath-care professional or medical journalist from anywhere in the world, you could still make your voice heard...let the Ontario legislature has the eyes of the medical community of the world fixed upon it.

6) In your response, make sure that you do NOT refer to them as "naturopathic doctors".  They're not doctors.  Doctors go to medical school.  They're naturopaths.  Naturopaths go to colleges that teach acupuncture, colonic irrigation and homeopathy.  They're not primary heath-care providers, and it's time we started calling them on their linguistic manipulation.

I wasn't able to find out when the third (and final) reading will take place, but it will be VERY soon.  Please help get the word out, and we may still be able to save health care standards in Ontario.  It's generally the way of things that wherever Ontario goes, so goes the rest of Canada.  If we stop them here, then perhaps Manitoba and Alberta (which are also considering similar legislation) can be saved.

Please spread this on your Facebook, Twitter, and any other social networking site you can get your hands on.  Ontario urgently needs your help.

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I have sent emails to my MPP ( a Conservative), and the Liberal MPPs in two adjacent ridings in which I spend significant time working, at sports clubs, and visiting my parents. I have urged them to visit the Skeptic North articles, and this one, and to help stop this bill from passing in its current form. I will let you know if I receive any responses.

Call me Paul said...
November 21, 2009 at 10:30 PM  

Added D. McGuinty to that list as well.

Call me Paul said...
November 22, 2009 at 12:58 AM  

Hey there,
I wrote a letter and got the NDP form letter too. I looked all through Bill 179 however, and I couldn't find where it says anything about "schedule 1 drugs". Can you give the exact place where the amendment says naturopaths get new prescribing privileges? It would help to cite it in my follow-up letter to the NDP rep. Thanks,

Heathen Mike said...
November 24, 2009 at 9:35 PM  

What I sent...

Dear Premier McGuinty, Minister Matthews, Ms. Horwath, Mr. Hudak, and Members of the Standing Committee on Social Policy:

My name is Stephen Livingston. I am a former assistant professor of psychology at the University of Toronto Scarborough. More importantly, I am a citizen of Ontario. I have lived in Toronto for two years and I am proud to call it my new home.

My wife and I, like millions of other Ontarians, rely on our elected representatives to help ensure that the laws of our land call for the highest quality of health care possible. It is therefore distressing to me that Bill 179 appears poised to pass a third reading in the Ontario legislature and therefore become law in this province.

As you are no doubt aware, Bill 179 in part proposes a revision to Subsection 4(1) of the Naturopathy Act of 2007 such that it will now read, in part:

4. (1) In the course of engaging in the practice of naturopathy, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following: ...

7. Prescribing, dispensing, compounding or selling a drug designated in the regulations.

Bill 179 also proposes adding relevant language to Section 11 ("Regulations") that grants designation rights for "the drugs that a member may prescribe, dispense, compound or sell for the purpose of paragraph 7 of subsection 4" to a Council comprised predominantly of members of the College of Naturopaths of Ontario.

As a citizen, I believe that people should have a general right to treat (or not treat) their own physical and mental maladies as they see fit. This includes, of course, the right to try whatever therapies they wish, and to consult whatever persons they wish about therapeutic options. I have no doubt that most naturopaths, like most health practitioners, have a genuine interest in restoring and maintaining their patients' well-being. And it is clear that there is many people are eager to try alternative medicine, perhaps because they have some condition that ordinary medicine cannot (and cannot promise to) treat successfully. However, as our representatives in matters of health laws and regulations, you must be careful to distinguish the "public interest" in the sense of curiosity from the "public interest" in the sense of the common good.

Steve Livingston said...
November 26, 2009 at 10:10 PM  


As a scientist, I do not see why the government or its constituents should have any interest in allowing practitioners of naturopathy to be given prescribing rights. Naturopaths offer a wide variety of treatments, including some that have apparent demonstrable therapeutic value (e.g., massage and acupuncture), some that have no demonstrable therapeutic value outside of placebo effects (e.g., homeopathy), and some that may even do demonstrable harm (e.g., herbal remedies that produce toxic metabolites). One of the core underpinnings of naturopathic training and theory is vitalism, a belief system that posits some self-directed "vital force" that behaves outside of the known laws of physics, chemistry, and biology. Many naturopathic "remedies" are centered around this untenable belief system.

Little evidence exists to suggest that naturopaths can or should be generally considered capable of providing adequate primary care to the citizens of Ontario. Indeed, in some cases naturopathic cures may prove worse than the ailment itself: either directly causing harm, or allowing additional harm to be caused through delay of evidence-based treatments. Therefore the "freedom of access" argument offered by the naturopath lobby (i.e., that granting prescribing rights will "free up" regular doctors to treat more patients) is faulty at its core.

I can assure you that I will be watching the final progress of this bill with particular interest, and that your respective party's support of Bill 179 will play a significant role in my family's voting decisions during the next election.

Please cast your support on the side of science and reason.

Most sincerely,

Stephen D. Livingston
North York

November 26, 2009 at 10:11 PM  

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