Department of Medical Law, University of Naples, Italy

ABSTRACT: Regulate the practice of homeopathic medicine; recognize legally the training of homeopathic physicians, which has already been created; provide homeopathic hospitals; include this treatment in national health programmes.

(Papers of the Transnational Conference: "THE HOMOEOPATIC REMEDY-NON-MEDICINE. A PROPOSAL FOR RECOGNITION" - Rome 12th and 13th december 1988).

Prof. Sciaudone developed with scientific rigour the situation of our practice, of the medical-homoeopathic activity in our country and did so with great competence and, above all, with juridical severity, as a jurist and not as a doctor because he succeeded in proving the legitimacy of the practice of this profession by the qualified doctor, regularly registered in the Medical List.

I shall here try to develop the "de jure condendo" situation, as the jurists call it.

We are here next to the place where laws are made, we are here to comment on a bill of law submitted by the Federalist Movement who has the merit of having understood that the State is trying to give an answer and to face certain needs of an ever greater number of people in Italy.

Though not a doctor, I shall start with a consideration on one of Hahnemann's basic concepts which caught my attention and that is the fact that there are two different therapeutic systems: that of Allopathic Medicine and that of Homoeopathic Medicine.

These two systems are completely different and absolutely incompatible.

This consideration may seem obvious to you who are working in the sector and are therefore probably ignoring a basic point which becomes more evident to those working in other fields.

If this, however, is the situation, that is a complete differentation between the two branches, if, as Professor Negro states, these two "medicines", if we may say so, speak a completely different language, if their attitudes towards diseases are completely different, one looking towards the diseased and the other towards the pathology, if the allopath and the homoeopath consider physiology and pathology in an absolutely different manner, then we find ourselves in two totally different worlds.

We are facing two different realities which in an absolutely transitory and substituting manner, may be unified, as Professor Sciaudone said, on the basis of existing laws, on the basis of new laws so that the request for Homoeopathic assistance may get a partial answer at least. However, if the legislator faces this request correctly, he will have to postulate responses entirely different from those given by the recovery of a juridic system, in a sanitary organization modulated, formulated, and created to meet the different requirements on the basis of other scientific interests, of other scientific evaluations, on the basis of a so-called dominating medical science, on the basis at times of consideration which are everything but scientific. I am speaking of the production, of the commerce of drugs and other such things which as everyone may see are degenerations of the system.

On the basis of the fact that Homoeopathic Medicine is something quite different from Allopathic Medicine and if we consider that we are here to debate on a bill of law regarding, though only partially, Homoeopathic Medicine, we have to decide, in the most complete possible way and in all the details, how the national or, according to competence, the regional legislator, can meet these requirements.

The introduction by Doctor Di Lascia lets us understand that the bill of law ignores the part regarding the training of doctors because in fact it only considers the acknowledgment of the Homoeopathic Remedies.

The bill of law whose first signatory was Maria Pia Garavaglia, regards things of this kind and that is the acknowledgment of the Homoeopathic Remedy.

The first observation that the jurist has to make on this is, as you all know, that the law arises from the fact "ex facto oritum ius" as the Romans said and, in fact, what the legislator must do is meet the requirements mentioned above.

But why bother about things which are not included in the bill of law? In enacting a law, the legislator should consider the need for a global discipline. I do not want to be misunderstood. I fully approve of the initiative of the Federalist Group which has come up with this proposal in a technically perfect manner. This, however, has to be detailed and completed if we wish to give a clear contribution to the Homoeopathic activity in our country.

Why then are the legislator's answers partial and based on negativity? Because Homoeopathic Medicine has become a fact. It has become the fact from which the law must arise, it has become a fact with its 600 and more doctors, it has become a fact with its one million patients who employ this Remedy in our country, the hundreds or maybe thousands of chemistries which sell the Remedy, it has become a big business, as we say today, and for some it has become an occasion for mystification. As Professor Sciaudone said it has become a "portfolio medicine", with conceptual alterations because from what I have gathered so far everything that is not accounted for in Hahnemann's Medicine as outlined during these meetings is mystification and an attempt of passing for Homoeopathic Medicine something which has nothing to do with it.

If this is the actual situation, the negative facts, from which the attempt to disciplinate the subject arises, the attempt to avoid abuses and put a stop to mystifications, let us then try to give a positive contribution.

What could this contribution be? Firstly, the training of the Homoeopath. This is the essential starting point, because in a transitory situation connected to a previous organization, it is necessary to seek, as Professor Sciaudone has so brillinatly done, the juridical instruments which allow to practice the profession. We must bear in mind, however, that one thing is the legitimacy and the conformity of a behaviour to a law and another thing is the interpretation the legislator gives of the needs of the citizens.

As you all know, university degrees entitle one to the practice of the profession and in many cases the doctor coming from a State University, as Professor Negro said, has been taught to speak a language which is entirely different from the one he speaks in the practice of his profession. Yet the doctor's degree is the citizen's only safeguard, the only means he has to know that his doctor is really a doctor.

According to me, in the present developing situation, in the present growth, in the present importance, both as regards quantity and quality, of Homoeopathy in our country, the above does not meet the requirements of a civilized country.

How can we solve the problem? Professor Sciudone pointed out the solution on the basis of the situation existing in other European and non European countries; the establishment of a faculty or course in Homoeopathic Medicine, examinations in Homoeopathic Medicine inserted in already existing courses, a specialization or the specialization in Homoeopathic Medicine.

According to me, if we bear in mind the absolute difference of Homoeopathic Medicine, the best solution would be the establishment of a degree course in which the student may face right from the start the study of medicine from the Homoeopathic viewpoint.

The legislator, however, has to raise the issue of compatibility with a pre-existing culture, with the background, the traditions and probably the institution of an autonomous degree course in Homoeopathy which would not easily fit into the cultural tradition without causing problems and imbalances.

As things stand at present, I would rather favour the establishment of a specialization in Homoeopathic Medicine or the institution of a Homoeopathic orientation within the Faculty of Medicine and Surgery.

We know from previous experience that the establishment of university degree courses which were deemed too far off from our cultural tradition were accepted with diffidence. For instance, the course in Dentistry and Dental Prosthesis caused the dentist with this degree to be considered, by the dominating medical science, almost as a second category operator in the medical field and not a doctor.

I believe that we should find a new training system compatible with our system of university and post-graduate education, compatible with our scientific tradition and in accordance with our cultural tradition. According to me this compatibility could perhaps be found in a specialization course.

This of course, as already said by those who proposed the legislation, is a much more complex problem and I sincerely praise their initiative as it is the first step and it had to be taken. But there is more to be done and it has to be done now because the menagement of this medicine, of this kind of medicine, cannot be entrusted to those who, as already said by Professor Negro, speak an entirely different language, read in a completely different key.

What can we anticipate? We are all here today thanks to the initiative of the Federalist Group and to the initiative of the Association for a Free University of Homoeopathic Medicine which is an institution which has faced the problem of vocational training in an exemplary manner as shown here today by its member students who brilliantly and competently illustrated the clinical cases treated by them.

We have a private structure, therefore, which trains these doctors, which forms the Homoeopaths and, as you know, our constitutional system acknowledges and recognizes the validity of private, non governmental education.

We have some very good examples of non governmental universities such as the LUISS in Rome, the Catholic University and the Bocconi University in Milan. In a transitory situation such as the present one, in the time necessary to reform university legislation those concerned could try to obtain some kind of regulation such as the one regarding psychologists, some kind of law which allows doctors who have practiced for a certain lapse of time, a special right to practice as a homoeopathic doctor so that the citizen who turns to Homoeopathic Medicine knows exactly who to consult and knows too that this person has previous experience in the practice of Homoeopathy.

I think that it is absurd to allow the practice of Homoeopathic Medicine if the doctor cannot openly advertise his activity. This is one of the many Byzantine heritages of our country.

Thus, let us disciplinate the practice of Homoeopathic Medicine and insert an item providing for a transitory situation before the system is reformed, a clause acknowledging the already trained homoeopaths and allowing only the latter, that is those who speak this kind of language, those who have almost been accused of witchcraft, considered as non doctors, but have had the courage, through self-sacrifice and determination, to study, learn and practice a medicine which in some way alienated them. This is the first point.

The second point is that our Constitution gives the Italian citizen the greatest liberty to cure himself as best he cares. As things stand, however, and the law 833 of the National Health Service is an example, there is a concrete differentiation of this right to cure oneself in the forms amd manners thought best.

Why is this? Doctor Kennedy spoke of hospital that apply Homoeopathic Medicine in England; in India, too, there are many public structures where homoeopathic treatment is employed; in our country, no however, there are no public structures providing for homoeopathic treatment and, as a result, the constitutional right to cure oneself as one pleases becomes null and void.

If I employ homoeopathic treatment all life long, but then have to be hospitalized for some reason or other, I have to turn to the only kind of medicine, which as we have already said is entirely different from homoeopathy, employed in public structures. If I have to turn to allopathic medicine, if I have no choice, the right guaranteed by the constitution falls through.

The law could thus provide for the establishment of homoeopathic hospitals or, more realistically, for homoeopathic departments within the existing hospitals. There would probably be no need for the national legislator, but the regional or perhaps even the local legislator would be sufficient. Of course, such hospitals or departments should have self-sufficient lateral services having nothing to do with the rest of the hospital structure: laboratory, X Ray, pathologic anatomy service, etc.. This reform would not be very expensive and could be carried out only in the most important towns, but would certainly be compatible with the financial capacities of our health system.

The third point comes from the fact that the citizen has to pay the Homoeopathic Remedies. This of course discourages the citizen from turning to this kind of therapy, to this kind of medicine seeing that the allopathic drug is free or greatly reduced.

This difference which may seem only marginal, is in fact a compression of the right sanctioned by the Constitution to choose the best possible treatment.

I believe that these three points can conclude my talk. Other points will certainly come up, but I believe that these points should form the basis on which to build and complete the bill of law which I deem technically valid, politically correct and which considers the ever growing needs of our population.