An alternative way to die

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Scientific progress has led to great advances in medicine and, at the same time, it has allowed to walk along new paths by applying treatment methods based on quite different principles from those already consolidated. Thus, besides classic medicine, defined as allopathic, has made its way homeopathic or ayurvedic medicine. The use of the latter, based on a cultural heritage of Indian origin, has been recently examined by the Supreme Court.

The supreme organ of justice has defined this medical practice as “treatments with medications whose curative effects are unknown and unproven”; and it recalled, in relation to the assessment of the duties of the accused physician, in the case under examination, that in a therapeutic relationship, especially when one must practice long-term therapies, that is a continuous activity, the doctor assumes an actual warranty position.  Moreover, it must be remembered that the National Science Foundation has defined alternative medicine as “all those treatments that have shown no effectiveness during scientific tests”.

The doctor advised to the family ayurvedic treatments which resulted in the death of the patient, a child entrusted to him by the family, that agreed and even welcomed alternative treatments.  However, it is said, even when the parents of a minor ask for treatment methods that are alternative to conventional medicine or accept them, the physician is responsible for the negative consequences, the failure, or the interruption of traditional therapies. In fact, it is up to them to anticipate the possible unfitness of ayurvedic therapy – or other non-traditional treatment methods which are not recognized by scientific literature nor by the guidelines approved by the scientific community itself, – considered to be insufficient by itself, to guarantee truly therapeutic alternative solutions. Hence the doctor must forestall the real consequences to which could lead the abandonment of traditional therapy.

In complicated cases, the physician has also the duty – in front of a parental choice oriented toward options that are risky for the health of their minor children – to involve in the decision-making process the institutions responsible for the public protection of the child (the doctor; the courts; etc.) This is because it a legally correct and substantially more profitable dialogue for the identification of the best option for the minor is required. Put otherwise, the doctor can never be deemed not to be responsible when (s)he has failed its legal obligations of effective therapeutic intervention: that can be always asked of him, from the very first intervention.

When an infectious aggression, as in the examined case, has not been adequately contrasted with the necessary antibiotic therapy (scientifically proven to be effective for the purpose of the containment of the infectious risk), the doctor who advised and recommended alternative treatments must be held responsible.

Taking into account the fact that subtraction of the patient to the necessary antibiotic treatment and the omission of the periodic medical checks have worsened the general situation, rendering the minor helpless, whereas a strong therapeutic response should have been requested.

As it can be observed, therefore, without any intention to prejudicially condemn alternative medicine which today is making its way in our system (also in cultural terms),  one certainly needs to understand that, in this context, in the mechanism of experimental assessment, the results have never offered scientific evidence of efficacy, and it is, therefore, necessary to use a really profound caution in undertaking new paths, in the US health care system referred to as  “complementary”.

But on the whole we must never forget that health is a primary good for the individual and precisely for this reason, the doctors must be aware of the importance of a full information it is their duty to provide their patients with, accompanying them throughout the entire time of the disease.

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