רפואה משלימה בהולנד

BMJ 2006;332:929 (22 April) Dutch doctors suspended for use of complementary medicine Tony Sheldon Utrecht The Amsterdam Medical Disciplinary Tribunal has struck off one doctor AND suspended two others for their exclusive use of complementary treatments—including "vegatests," homoeopathic medicine, AND food supplements—to treat Sylvia Millecam, the Dutch actor AND comedian who died from breast cancer in 2001 at the age of 45 (BMJ 2004;328: 485[Free Full Text]). In the high profile test case for use of complementary medicine the doctors, who were not identified by the tribunal, were judged to have ignored existing standards for treating breast cancer, used unsatisfactory methods, AND withheld information during their treatment of Ms Millecam. She opposed conventional medicine AND sought help from a doctor who also practised complementary medicine after she was given a diagnosis of breast cancer in May 2000. The stiff measures are seen as a strong warning that doctors must urge seriously ill patients to seek conventional care. The tribunal found two of the doctors to have denied Ms Millecam "a reasonable chance of recovery," in particular by failing to refer her to a breast cancer specialist. The third doctor was judged to have caused her "unnecessary suffering" by withholding conventional palliative care as her condition deteriorated. However, the tribunal concluded that the doctors were not responsible for her death. After the diagnosis Ms Millecam was recommended to have chemotherapy AND surgery, but instead she sought treatment from an internist AND practitioner of complementary medicine, identified by the tribunal as "D," who "let it slip" that she did not have cancer AND treated her with various complementary treatments. Later she turned to a GP, identified as "B," who carried out a vegatest, which measures the electrical resistance of connective tissue under the skin. This doctor diagnosed a bacterial infection, which he treated using non-registered medicines, thus leaving the cancer untreated for months. With the tumour now advancing AND spreading, causing Ms Millecam increasing pain AND breathlessness, she turned to a family friend, a GP identified as "K," who instead of administering conventional drugs for pain relief used a magnetic field apparatus called "Lotje"—so called dark field microscopy—to try to identify blood disorders. He also used homoeopathic treatments AND food supplements. Ms Millecam was admitted to hospital in August 2001, where she died four days later. B, who had previously been suspended for six months for using similar complementary treatments, has been banned from practising as a doctor. The tribunal suspended K for one year AND D for six months. They concluded that despite Ms Millecam's known resistance to conventional treatment a registered doctor should have made it clear that such treatment offered the only chance of recovery. Johan Legemaate, professor in health law at Amsterdam's Free University, said, "Alternative medicine can be combined with, but never replace, regular evidence based care."