CAMLAW: Complementary and Alternative Medicine Law Blog : Complementary, Alternative, & Integrative Medicine Law, Regulation, Ethics & Policy (Alternative and Complementary Medicine, Medical Spa Information, Holistic Health Attorney, and Legal Resources)

Although acupuncture malpractice may be rare, experts can be deployed to help mitigate liability (for defendants) or make the liability case (for plaintiffs).

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Here's what you need to know about legal issues involved in practicing complementary and alternative medicine....

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Many medical spas, health care clinics, integrative medicine facilities, and wellness facilities are asking whether sharing revenues with practitioners violates the law and puts them in legal jeopardy.

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New York has its own "mini-Stark" law addressing referrals to health care entities in which the referring practitioner has an ownership or other financial interest.

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Integrative medicine clinics, wellness centers, and other holistic health care facilities (and medical spas) can incur both direct and vicarious liability.

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An emerging case against a psychiatrist highlights conflict of interest issues involved when physicians promote products, particularly those involving off-label drug use.

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A new case sheds light on malpractice liability that may attach to chiropractors treating patients with serious medical conditions.

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A $4.1 million medical malpractice judgment was awarded for negligence by a Tennessee nursing home.

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The Chicago Accident Law Blog takes up the argument that Internet prescription drug overdoses are a threat to public health in the United States.

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Laws in several states mandating disclosure of medical errors protect physicians to apologize and offer expressions of grief without their words being used against them in court.

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The Health Care Law Blog brings news of a new Kentucky case, reiterating the legal principle that medical expert testimony is not always necessary to show negligence (medical malpractice).

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Personalized medicine is also known as "pharmacogenomics," and now is bringing together legal and ethical experts.

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An article in Neurology warns that class-action lawsuits unnecessarily impede important scientific discoveries.

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A jury awarded $1.5 million in a negligence and medical malpractice lawsuit against two physician assistants, a pediatrician and Southeastern Regional Medical Center.

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Negligent supervision of non-physician health care providers (such as nurses) can be a basis for a medical malpractice (negligence)lawsuit, whether the therapy involved is conventional or complementary (alternative).

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Medical malpractice is ably canvassed in a Florida blog, referencing law beyond the state as well.

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According to a study published in the Annals of Internal Medicine, physician errors are a factor in about 60% of medical malpractice claims that involved patients allegedly injured because of missed or delayed diagnoses

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"Integrative Medicine Gains a Mainstream Foothold" by AJS Rayl, MA appeared in the October 2005 issue of Applied Neurology.

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As few cases involving allegations of medical malpractice for use or complementary and alterantive medical (integrative) therapies result in reported judicial opinions, it helps to track claims, or better yet, learn via the 'grapevine' of current cases and upcoming litigation.

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Pediatrics recently published our article on complementary therapies in pediatric care. The article offers a framework for clinical decision-making.

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The table below summarizes some of the major grounds of potential legal claims with which clinicians, institutions, and associations should be concerned.

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Here's a brief summary and analysis of two important cases concerning claims of CAM malpractice: Charell v. Gonzales, and Schneider v. Revici.

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I worried about this question in Cohen MH. Malpractice considerations affecting the clinical integration of complementary and alternative medicine. Curr Prac of Med 1999;2:4:87-89. The reason was this: malpractice is defined as (1) deviation from the standard of care, which (2) causes the patient injury. "Alternative medicine" was also being defined as using that fall outside conventional medicine. Presto: alternative medicine equals malpractice. This was the conclusion of one judge in a New York case called Charell v. Gonzales.

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In Cohen MH, Eisenberg DM. Potential physician malpractice liability associated with complementary/integrative medical therapies. Ann Intern Med; 2002;136:596-603, my colleague David M. Eisenberg, M.D. of Harvard Medical School, and I offer a framework for physicians grappling with medical liability issues as complementary and integrative health care practices are made available in conventional medical settings.

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The popularity of complementary and alternative medicine (CAM) poses serious challenges for the physician and other providers, not the least being the issue of informed consent.

In Ernst EE, Cohen MH. Informed consent in complementary and alternative medicine. Arch Intern Med 2001;161:19:2288-2292, my colleague Edzard Ernst, MD, PhD (from across the Atlantic at the University of Exeter) and I review the legal and ethical implications of informed consent in CAM therapies.

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Informed consent presents one of the major unresolved areas in the integration of complementary and alternative therapies into the health care system. Legal requirements of informed consent aim to protect the patient against non-consensual interference with his or her body in medical matters. Informed consent requires the physician to disclose, and ensure that patients (or authorized surrogates) comprehend, all information material to the patient's decision to undergo or reject a specific medical procedure. Inclusion of complementary and alternative medicine in any such requirement is likely to have a significant impact on clinical practice....

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