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Defining a Standard of Care in the Practice of Acupuncture
Published online by Cambridge University Press: 06 January 2021
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In 1971, New York Times journalist James Reston watched as brain surgery was preformed in the former Red Cross Hospital in Shanghai with acupuncture as the only anesthesia. “[Patients] were anesthetized merely by the insertion of very thin three-inch stainless steel needles into the body … and they were not only perfectly conscious while their skulls were laid open before us but remarkably alert within half an hour after the operation.” One patient, a fifty-four-year-old man named Chuan Leao, had been suffering from epilepsy as a result of a large tumor in the frontal lobe of his brain. “He seemed sensibly puzzled by being introduced to a couple of American strangers during his ordeal but was courteous and patient, and we listened to his comments while the tumor was removed and even watched him eat oranges slices and ask for more while the operation was going on.”
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References
1 Reston, James, A View From Shanghai, N.Y. TIMES, Aug. 22, 1971Google Scholar, at E19.
2 Id.
3 Id.
4 Id.
5 Id.
6 Id.
7 Id.
8 Id.
9 PETER ECKMAN, IN THE FOOTSTEPS OF THE YELLOW EMPEROR: TRACING THE HISTORY OF TRADITIONAL ACUPUNCTURE xiii (1996).
10 See id.
11 Reston, supra note 1, at E19.
12 NAT’L INSTITUTES OF HEALTH, ACUPUNCTURE CONSENSUS DEVELOPMENT CONFERENCE STATEMENT 107, available at http://odp.od.nih.gov/consensus/cons/107/107_statement.htm.
13 See NAT’L CTR. FOR COMPLEMENTARY & ALTERNATIVE MED., GET THE FACTS: ACUPUNCTURE, at http://nccam.nih.gov/health/acupuncture/ (last modified Jan. 25, 2005).
14 See id.
15 See generally Goldstein, Michael S., The Persistence and Resurgence of Medical Pluralism, 29 J. Health Pol. Pol’Y & L. 925 (2004)CrossRefGoogle ScholarPubMed (discussing various alternative medicines, including acupuncture).
16 ECKMAN, supra note 9, at 3.
17 JOHN H. BERTHRONG, TRANSFORMATIONS OF THE CONFUCIAN WAY 11 (1998).
18 See NAT’L CTR. FOR COMPLEMENTARY & ALTERNATIVE MED., NAT’L INST. OF HEALTH, GET THE FACTS: ACUPUNCTURE, at nccam.nih.gov/health/acupuncture/ (last revised Dec. 2004).
19 See id.
20 See id. (explaining that yin and yang are defined as the Chinese concept of negative and positive energy forces in the universe and human body and acupuncture is believed to remove yin or yang imbalances and bring the body into balance); see also Acupuncture: NIH Consensus Development Panel on Acupuncture, 280 JAMA 1518, 1520 (1998)Google Scholar (stating that acupuncture may correct imbalances at identifiable points close to the skin).
21 RUSSELL J. ERIKSON, GUIDE FOR PHYSICIANS SEEKING HOSPITAL AND HMO PRIVILEGES, at http://www.medicalacupuncture.org/acu_info/priv.html (last visited Oct. 9, 2003).
22 AM. ACUPUNCTURE, THE HISTORY OF ACUPUNCTURE at http://www.americanacupuncture.com/history.htm (last visited Dec. 3, 2003); see also ECKMAN, supra note 9, at 39 (stating that there has been evidence of acupuncture since 1000 B.C., though the practice might go back as far as 3000 B.C.).
23 TED J. KAPTCHUK, THE WEB HAS NO WEAVER: UNDERSTANDING CHINESE MEDICINE 133 (2000).
24 Id. at 109.
25 AM. ACUPUNCTURE, supra note 22.
26 ECKMAN, supra note 9.
27 See id.
28 See id.
29 Id.
30 Naomi Freundlich, The Point of Acupuncture, REAL SIMPLE, March 2004, at 112.
31 AM. ACUPUNCTURE, Weight Loss and Acupuncture, at http://www.americanacupuncture.com/weight.htm (Feb. 27, 2005).
32 Freundlich, supra note 30 (“More than 60% of people who see acupuncturists are looking for pain relief.”). “[Infertility] has been one of the fastest-growing areas of treatment since the 2002 publication of a German study that found that more than 40 percent of women undergoing in vitro fertilization who received acupuncture became pregnant (compared with 26 percent without acupuncture) …. Zev Rosenwaks, M.D., director of the CRMI, says that while there are a great number of biological explanations for acupuncture's benefits to fertility, there has yet to be a definitive clinical study.’” Id. at 112-14.
33 Id. at 112.
34 Haavi Morreim, E., A Dose of Our Own Medicine: Alternative Medicine, Conventional Medicine, and the Standards of Science, 31 J. L. Med. & Ethics 222, 230 (2003)Google Scholar.
35 NAT’L CTR. FOR COMPLEMENTARY AND ALTERNATIVE MED., NAT’L INSTITUTE OF HEALTH, at http://nccam.nih.gov/about/aboutnccam/index.htm (Feb. 27, 2005).
36 See id.
37 Morreim, supra note 34.
38 NAT’L INSTITUTES OF HEALTH, supra note 12.
39 Id.
40 Id.
41 Id.
42 MASS. GEN. HOSP., Mass. General to Study Acupuncture Treatment for High Blood Pressure, at http://www.sciencedaily.com/releases/2001/04/010412080632.htm (Apr. 4, 2001).
43 Id.
44 Eissenberg, David et al., Trends in Alternative Medicine Use in the United States, 1990- 1997: Results of a Follow-up National Survey, 280 JAMA 1569, 1569 (1998)CrossRefGoogle Scholar.
45 Id.
46 Id.
47 Freundlich, supra note 30, at 111.
48 Elayne B. Howard & Karin Gillespie, A Break From Tradition, AM. MARKETING ASS’N MARKETING HEALTH SERVICES, Summer 2003, at 15, available at http://www.elaynehowardassociates.com/news/docs/eha_mhs03.pdf.
49 NAT’L INSTITUTES OF HEALTH, supra note 12.
50 Leake, Robin & Broderick, Joan E., 5 Alternative Therapies, No. 4 (July 1999)Google Scholar available at http://www.medicalacupuncture.org/acu_info/licensure.html (Feb. 26, 2005) (stating that Alabama, Delaware, Georgia, Illinois, Indiana, Kansas, Kentucky, Michigan, Mississippi, Nebraska, North Dakota, Ohio, Oklahoma, South Dakota, Tennessee, and Wyoming do not currently provide for certification or licensure for acupuncturists).
51 Id. (stating that Alabama, Deleware, Georgia, Illinois, Indiana, Kansas, Kentucky, Michigan, Mississippi, Nebraska, North Dakota, Ohio, Oklahoma, and Tennessee, though they do not provide for certification or licensure of acupuncture, do allow the practice of acupuncture within the scope of practice for physicians).
52 Id.
53 Id.
54 Id.
55 Cohen, Michael H., Complementary And Alternative Medicine, Legal Boundaries And Regulatory Perspectives 43 (1998)Google Scholar.
56 Id.
57 Van Hemel, Peter J., A Way Out of the Maze: Federal Agency Preemption of State licensing and Regulation of Complementary and Alternative Medicine Practitioners, 27 Am. J.L. & Med. 329, 334 (2001)Google ScholarPubMed.
58 See Goldberg, Barbara D., Defense Strategies for Cases Involving “New” Medicine: As Alternative Treatments Increase, So May Malpractice Claims, 16 Med. Malpractice L. & Strategy 1, 3 (1999)Google Scholar.
59 See id.
60 Van Hemel, supra note 57, at 335.
61 Goldberg, supra note 58, at 1-2.
62 Id.
63 See Rotchford, James K., Overview: Adverse Events of Acupuncture, 11 Med. Acupuncture (Fall 1999 – Winter 2000)Google Scholar available at http://www.medicalacupuncture.org/aama_marf/journal/Vol11_2/adverse.html.
64 Konstantinidis v. Chen, 626 F.2d. 933, 935 (D.C. Cir. 1980).
65 Id.
66 Id. at 940.
67 Rotchford, supra note 63.
68 Id. (“This estimate is based on [Rotchford’s] personal experience of approximately 30,000 treatments over a 15-year period, plus a review of the current literature on adverse events in acupuncture.”).
69 Id.
70 Id.
71 Studdert, David M. et al., Medical Malpractice Implications of Alternative Medicine, 280 JAMA 1610, 1611 (1998)CrossRefGoogle ScholarPubMed.
72 Id. at 1611-12.
73 See Furrow, Barry R. ET AL., Health Law 170 (4th ed. 2001)Google Scholar.
74 Id. at 174.
75 Id. at 175.
76 Id. at 171; see Hall v. Hillbun, 466 So. 2d 856, 873 (Miss. 1985) (“[T]he physician's nondelegable duty of care is this: given the circumstances of each patient, each physician has a duty to use his or her knowledge and therewith treat through maximum reasonable medical recovery, each patient, with such reasonable diligence, skill, competence, and prudence as are practiced by minimally competent physicians in the same specialty or general field or practice throughout the United States, who have available to them the same general facilities, services, equipment and options.”).
77 Chumbler v. McClure, 505 F.2d 489, 492 (6th Cir. 1974).
78 See generally FURROW ET AL., supra note 73, at 224.
79 Brook v. St. John's Hickey Mem’l Hosp., 380 N.E.2d 72, 76 (N.Y. 1978).
80 See generally Goldberg, supra note 61.
81 COHEN, supra note 55, at 58.
82 Goldberg, supra note 61.
83 Id.
84 Id.
85 N.Y. PUB. HEALTH LAW § 230(1) (2004).
86 See Goldberg, supra note 61.
87 Howard & Gillespie, supra note 48, at 15.
88 Id.
89 Ostrowski v. Azzara, 545 A.2d 148 (N.J. 1988).
90 Schneider v. Revici, 817 F.2d 987 (2d Cir. 1987).
91 Id. at 991.
92 Id. at 996.
93 Lowery v. Newton, 278 S.E.2d 566 (N.C. Ct. App. 1981).
94 Johnson by Adler v. Kokemoor, 545 N.W.2d 495, 501 (Wis. 1996).
95 Howard & Gillespie, supra note 48, at 16.
96 Id.
97 Doyle, Aimee, Alternative Medicine and Medical Malpractice, 22 J. Legal Med. 533, 540 (2001)CrossRefGoogle ScholarPubMed (citing Eisenberg, David et al., Unconventional Medicine in the United States: Prevalence, Costs, and Patterns of Use, 328 New. Eng. J. Med. 246 (1993)CrossRefGoogle ScholarPubMed).
98 Id. at 536.
99 Id. at 542 (citing Cooper, Richard A. & Stoflet, Sandi J., Trends in the Education and Practice of Alternative Medicine Clinicians, 15 Health Aff. 226 (1996)CrossRefGoogle ScholarPubMed). The number of cancer patients currently using alternative therapies, including acupuncture have probably increased since the article was published in 1996.
100 Id. at 540 (citing WILLIAM J. CURRAN ET AL., HEALTH CARE LAW AND ETHICS 234 (5th ed. 1998)).
101 See id. at 536-40.
102 CENTER FOR SUBSTANCE ABUSE TREATMENT, U.S. DEP't OF HEALTH & HUMAN SERV., Treatment Improvement Protocol (TIP) Series 33 Consensus Panel (1999) (treatment for stimulant use disorders includes acupuncture in its clinically based recommendations) available at http://www.guideline.gov (Nov. 3, 2003). This guideline has since been “withdrawn from the NGC Web site because they no longer meet the NGC Inclusion Criteria with respect to date, or because the guideline developer has indicated that the clinical practice guideline upon which the summary is based is obsolete, should no longer be used, or has not yet been replaced with a new/revised guideline.” NAT’L GUIDELINE CLEARINGHOUSE at http://www.guideline.gov/resources/summaryarchive.aspx2540.
103 See NATIONAL GUIDELINE CLEARINGHOUSE, U.S. DEP't OF HEALTH & HUMAN SERV., Brief Summary: Clinical Practice Guideline for the Management of Postoperative Pain, at http://www.guideline.gov/summary/summary.aspx?doc_id=3284&nbr=2510&string=postoperativeANDpain (Jan. 14, 2003).
104 NAT’L GUIDELINE CLEARINGHOUSE, U.S. DEP't OF HEALTH & HUMAN SERV., Clinical Practice Guidelines: Options for Post Operative Pain Management, available at http://www.guidelines.com (stating that acupuncture “[m]ay reduce nausea and vomiting if used in early post-operative period.”).
105 See NAT’L GUIDELINE CLEARINGHOUSE, U.S. DEP't OF HEALTH & HUMAN SERV., Brief Summary: The Management of Persistent Pain in Older Persons, at http://www.guideline.gov/summary/summary.aspx?doc_id=3365&nbr=2591&string=acupuncture (Jan. 12 2005).
106 Id.
107 See NAT’L GUIDELINE CLEARINGHOUSE, Brief Summary: Clinical Practice Guidelines for Chronic Non-malignant Pain Syndrome Patients II: An Evidence-based Approach, at http://www.guideline.gov/summary/summary.aspx?doc_id=2812&nbr=2038&string=nonmalignantANDpain (Nov. 26, 2001) (“According to the guideline developer, this guideline has been reviewed and is still considered to be current as of 2004.”).
108 Id.
109 Id. (“Given this, the current guidelines do not recommend the use of trigger point injections on a routine basis for chronic non-malignant pain syndrome patients until further evidence demonstrates the method produces significant effects.”).
110 See NAT’L CTR. FOR COMPLEMENTARY & ALTERNATIVE MED., supra note 13.
111 NAT’L INSTITUTES OF HEALTH, supra note 12.
112 Van Hemel, supra note 60, at 339.
113 NAT’L INSTITUTES OF HEALTH, supra note 12.
114 Id.
115 See Boozang, Kathleen M., National Policy on CAM: The White House Commission Report, 31 J.L. Med. & Ethics 251, 256 (2003)Google ScholarPubMed (“A further challenge is the difficulty of subjecting some forms of alternative treatments to a randomized, double-blind trial, because the treatment mode, such as acupuncture, does not readily lend itself to such a methodology.”).
116 NAT’L INSTITUTES OF HEALTH, supra note 12.
117 See id.
118 NAT’L CTR. FOR COMPLEMENTARY & ALTERNATIVE MED., Strategic Plan 2005-2009, available at http://nccam.nih.gov/about/plans/2005/draftstratplan.pdf (Oct. 2004).
119 Id. at 13.
120 Id.
121 Holcombe, Randall G., Eliminating Scope of Practice and Licensing Laws to Improve Health Care, 31 J.L. Med. & Ethics 236, 236 (2003)CrossRefGoogle ScholarPubMed.
122 See NAT’L CTR. FOR COMPLEMENTARY & ALTERNATIVE MED., supra note 1198, at 13.
123 See Brook v. St. John's Hickey Mem’l Hosp., 380 N.E.2d 72 (N.Y. 1978).
124 Howard & Gillespie, supra note 48, at 15.
125 But see Holcombe, supra note 121 (“People do not need to be experts in a particular area in order to locate high-quality providers, or to weed out low-quality providers.”).
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