Centrum Medycyny Naturalnej Akupunktura Fitoterapia 33-300 Nowy S ą cz ul. Kochanowskiego 30 Leonardo Da Vinci Project: PARTNERSHIP FOR PROFESSIONAL GROWTH IN COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) CAM- PROF Chronic Diseases Preparation of Code of Ethics Meeting on May 18, 2013 Stuttgart
Definition of chronic diseases � Chronic disease according to M. Zięcina (1976, s.156) "permanent irreversible, progressive, damaging changes in the structure, permanently debilitating, mainly in the acute, but also chronic, as one and the same constantly ongoing process of destruction ". � Chronic diseases include those “that are generally low severity, but often lead to permanent organ damage, can take several years, and recovery does not have to be synonymous with regaining full health” (Śródka,Encyclopedia of Health) � These definitions are focused on biomedical perspective, considering the three parameters, namely, the duration, course and consequences of medical illness
List of chronic diseases Poland Dz.U.09.35.276 → dated 5 March 2009 Regulation of Ministry of Health of February 2, 2009 on the list of diseases (congenital or aquired) and the list of medicines and medical devices, which, due to these diseases are prescribed free of charge, a flat rate or partial payment � 1) acromegaly, � c) breast cancer and endometrial cancer, � 2) asthma, chronic obstructive pulmonary disease, � d) breast cancer in the second wave endocrine therapy, eosinophilic bronchitis, � e) prostate cancer � 3) Alzheimer's disease, � 21) osteoporosis, � 4) disease and Parkinson's syndrome, � 22) epilepsy, � 5) Crohn's disease, � 23) refractory epilepsy, � 6) mental illness or mental retardation, � 24) primary ciliary dyskinesia, � 7) severe chronic obstructive pulmonary disease with a � 25) prostatic hypertrophy documented spirometric values of FEV1 <50% and a � 26) chronic ulcers, negative diastolic test, � � 27) schizophrenia, 8) diabetes, � � 28) in the case of schizophrenia reapse of psychotic symptoms 9) epidermolysis bullosa, during treatment with neuroleptics as a result of documented, � 10) phenylketonuria, persistent lack of cooperation of the patient, � 11) tuberculosis, including MDR-TB and other � 29) state vascularised organ transplant or bone marrow mykobakteriozy, � 30) status after resection of the pancreas, � 12) hypercholesterolemia LDL-C above 130 mg / dl despite � 31) state after myocardial infarction without ST segment elevation continuing statin therapy if: status after myocardial to 12 months of use, infarction or coronary revascularization (percutaneous or cardiac), the state of the peripheral revascularization or � 32) state after myocardial infarction with ST-segment elevation to amputation because of peripheral atherosclerotic disease, 30 days of use, familial hypercholesterolemia, � 33) multiple sclerosis, � 13) glaucoma; � 34) amyotrophic lateral sclerosis, � 14) myasthenia gravis, � 35) documented heart failure NYHA class II-IV NYHA, � 15) symptomatic coronary atherosclerosis treated with � 36) polysymptomatic local pain syndrome type - I reflex metal stents (up to 6 weeks after stent implantation) or sympathetic dystrophy, and type II - causalgia, drug-eluting stents antyrestenotycznymi (up to 12 months � 37) ulcerative colitis, after implantation of the stent) to prevent blood clots, � 38) teams congenital metabolic defects, food allergies, chronic � 16) pituitary diabetes insipidus, diarrhea, � 17) cystic fibrosis, � 39) Attention Deficit Hyperactivity Disorder in children over 6 � 18) chronic post-herpetic neuralgia, years of age � 19), hypothyroidism, � 20) malignant neoplasms, including: � a) neutropenia in cancer, � b) osteolytic metastasis in cancer,
Biomedical versus Holistic Approach � Biomedical: human health in this approach is meant only as a properly functioning biological organism. The disease is interpreted as a disruption of these normal functions of the human body � Holisitc: In contrast to the previous position human body is understood as more complex in addition to physical/somatic aspect together with mental and spiritual dimension. Health does not just refer to the efficiency of the biological system, but a state of dynamic equilibrium of many systems, including biological, psychological and social levels of functioning of the individual
Understanding code of ethics WHO (World Health Organiation) definition: � Ethics is concerned with moral principles, values and standards of conduct. The field of health and health care raises numerous ethical concerns, related to, for example, health care delivery, professional integrity, data handling, use of human subjects in research, and the application of new techniques, such as gene manipulation.
Cultural Perspective on code of ethics in Poland � Historically the first code related to medical ethics in Poland was published in print in 1876 � From 1952 - 1991 many provisions of the law came from the communist era. � Code of Medical Ethics published in 1991 is used to the present day � Currently ethical standards are influenced by Hippocratic ethics and Christian morality (the postion of the Roman-catholic Church)in relation to abortion, euthanasia, in vitro, stem cells research, human gene manipulation etc.
The content of the Polish Code of Medical Ethics: 1) the guidelines of doctor and patient relationship 2) the quality of medical care 3) respect of patients' rights 4) medical confidentiality 5) help patients in the terminal stages 6) organ transplant 7) procreation 8) medical certificates 9) research and medical experiments 10) relationships with industry practitioners 11) of the human genome 12) the mutual relations between doctors 13) best clinical practice 14) the physician and society
Important points to consider in code of ethics � patient´s rights, beneficence, non-male ficence, justice concerns (common values, influenced by cultural aspects i.e. abortion, euthanasia, etc.) � the distribution of health resources; availability of alternative treatment (Polish perspective: acupuncture and TCM herbal tx are not covered by National Health Insurance), � truth-telling, (should the doctor tell all about the poor prognosis, impact on the well being and psychological aspect of the individual) � confidentiality
Recommendation: Alternative Medicine Code of Ethics � As an example: AOM Profession (USA) Publishes Model Code of Ethics � In 1999, a panel at one of the AOM profession's national conferences addressed the issue of professional ethics. In 2001, a Joint Ethics Committee, composed of members of the American Association of Oriental Medicine (AAOM) and the Acupuncture and Oriental Medicine Alliance, began to work on a model code.
Recommendation: NCCAOM (USA) Code of Ethics � NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine) publishes Code of Ethics effective as of October 14, 2008 � All practitioners certified by NCCAOM must be committed to: � responsible and ethical practice, � to the growth of the profession’s role in the broad spectrum of American health care, � and to their own professional growth. � All Diplomates, Applicants and Candidates for certification agree to be bound by the NCCAOM Code of Ethics.
Recommended readings: � http://www.nccaom.org/regulatory-affairs/code-of- ethics � http://www.acupuncturetoday.com/mpacms/at/articl e.php?id=30005http://www.baab.co.uk/Down%20load able%20documents/BAcC%20Codes/5.%20Code%20of %20Professional%20Conduct.pdf � http://www.acupuncturesociety.org.uk/acupuncture_s ociety_code_of_ethics.php � http://www.tcminter.net/ � http://www.acupuncture.com/ � http://www.china-med.net/
Alternative medicine practioners in the region (malopolska region) � Gabinet Akupunktury i Ziołolecznictwa � ORIENT. MEDYCYNA NATURALNA wg Tradycyjnej Medycyny Chińskiej MOGILSKA 121B LOK. 704 ul. Emaus 4/1, Kraków 31-571 KRAKÓW, MAŁOPOLSKIE rejestracja tel. 0-602-270-252 http://www.medycynazintegrowana.pl/ � MEDYCYNA DALEKIEGO WSCHODU. � NaM Nature and Medicine SP. Z O.O. Plac Braci Duzińskich 1A ŚWITEZIANKI 3 30-556 Kraków, 31-563 KRAKÓW, MAŁOPOLSKIE � Gabinet Tradycyjnej Medycyny Chińskiej dietoterapia i akupunktura � Chinmed S.C. Wojciech Buła i S Ka ul. Witosa 21 (Centrum Medyczne Wojciech Buła Halina Dębczuk PLAST-MED) Kalwaryjska 30/6Kraków(12) 296-34-36 40-832 Katowice
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