21 February 2010
Re: The legal situation for the practice of homeopathy in JapanIntroduction
We are sending you this letter as we understand that the Government of Japan is currently considering
the introduction of legislation and/or regulation of the practice of homeopathy in your country. We
will hereby present to you our main points of concern, as well as an overview of existing legislation incountries in Europe.
The European Central Council of Homeopaths (ECCH)
The European Central Council of Homeopaths (ECCH) is a professional platform representing amembership of professional associations of homeopaths in 24 countries in Europe. This gives us agood overview and insight into the legislation, regulation and education of homeopaths across Europe.
ECCH enjoys NGO Participative Status with the Council of Europe, and is a member of the Brusselsbased European Commission funded European Public Health Alliance (EPHA).
The Japanese Homoeopathic Medical Association (JPHMA) is, together with another 31 associations
in Australia, New Zealand, Canada, the United States of America and Europe, a full member of theInternational Council for Homeopathy (ICH). These members all represent associations of homeopaths
practising homeopathy which meet our standards and requirements for professional associationmembership.
The practice of homeopathy by healthcare practitioners and other professionals
In the majority of European countries, homeopathy has for decades been practised both byhomeopaths who are statutorily regulated healthcare practitioners and by those who are not (ECCH2009). An increasing number of national Governments have over recent years positively regulated thepractice of homeopathy and other CAM therapies. This involves legalising the practice of homeopathy
for those practitioners who are statutorily regulated healthcare practitioners, as well as those who are
not, so that they are legally entitled to practise. Examples of such countries include Belgium, Iceland,Liechtenstein, the Netherlands, Norway and Portugal (see appendix A).
We strongly recommend that legislation in your country allows for patients to have the freedom tochoose homeopathic treatment from well-trained and well-regulated homeopaths and healthcare
practitioners who meet the education and registration standards of their national registering body (seeappendix B). This would also be in line with the Council of Europe’s 1999 Resolution 1206 on Nonconventional Medicines, which states that:“The Assembly believes that in the future alternative or complementary forms of
medicine could be practised by doctors of conventional medicine as well as by any
well-trained practitioner of non-conventional medicine (a patient could consult one or
the other, either upon referral by his or her family doctor or of his or her free will),should ethical principals prevail.”Moreover, in their strategic policy report entitled “Traditional Medicine Strategy 2002-2005” theWorld Health Organization (WHO) recommended (page 26): Key needs in promoting sound use of
TM/CAM by providers and consumers should include:

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At national level:• Training guidelines for most commonly used TM/CAM therapies• Strengthened and increased organisation of TM/CAM providers• Strengthened cooperation between TM/CAM medicine providers and allopathic medicine
practitioners• Reliable information for consumers on proper use of TM/ CAM therapies and products
We would like to point out here that the WHO did not recommend that all TM/CAM should bepractised by medical doctors. Moreover, the Japanese Homeopathic Medical Association (JPHMA)
has already for several years introduced training guidelines for the education of homeopaths as well as
a number of other measures to ensure the effective and safe treatment of their patients.
The safety of homeopathy
The safety of the practice of homeopathy has been considered by a number of researchers. The
European Central Council of Homeopaths (ECCH) has developed a report which summarises thefindings, which include:•••

Homeopathic medicinal products are safe to use as they are highly diluted and therefore can notcause any toxicologically harmful effects on human beings
Research evidence on reported adverse events and adverse drug reactions also show that
homeopathic medicinal products are safe to use
Cases of unethical practice or malpractice by practitioners are extremely rare

In your efforts to introduce regulation of CAM practitioners we would like to point out that it is anunderstood principle that homeopathy practitioners do not carry out medical diagnosis (see appendix
B). Homeopaths rely on each patient they treat having access to the services of a qualified medical
doctor for this purpose and for conventional treatment when it is needed. Homeopaths are trained toknow when it is necessary to refer patients to medical doctors. The full ECCH safety report may befound and downloaded at www.homeopathy-ecch.eu
Involve the JPHMA in your national consultation process
We would strongly encourage the Japanese Government to involve the Japanese Homeopathic
Medical Association (JPHMA) in its process of considering the establishment of legislation andregulation of the practice of homeopathy in Japan, as they have introduced high quality standards forthe practice of homeopathy, and as they have also gained membership of the International Council forHomeopathy (ICH).
For further information we would like to refer you to attachments A and B.
We would be happy to provide you with any further necessary information.
Yours sincerelyStephen Gordon
Petter Viksveen
ECCH General Secretary
ECCH Chairman--------------------------------------------------------------------------------------------------------------------------European Central Council of Homeopaths
School House, Market Place, Kenninghall, NR16 2AH Norfolk, United Kingdom
Tel/fax: + 44 1953 888 163 Website: www.homeopathy-ecch.eu E-mail: ecch@gn.apc.org
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Appendix A
European and national legislation and regulation
1. The Council of Europe’s CAM Resolution
In 1999 the Council of Europe published an important position paper on CAM. Reference: AEuropean Approach to Non-conventional Medicines Resolution 1206 1999. The resolutions state that:“The Assembly believes that the best guarantee for patients lies in a properly trained profession, which
is aware of its limitations, has a system of ethics and self-regulation and is also subject to outsidecontrol. It would be unrealistic to wish to prevent the emergence of new professions in the healthsector. The regulations that currently exist in certain European countries on the practice of one or otherform of non-conventional medicine open the way for progress. The Assembly calls on the member
states to model their approach on their neighbours' experiments and, whenever possible, to co-ordinate
their position with regard to these medicines.”“The Assembly believes that in the future alternative or complementary forms of medicine could bepractised by doctors of conventional medicine as well as by any well-trained practitioner of nonconventional medicine (a patient could consult one or the other, either upon referral by his or her
family doctor or of his or her free will), should ethical principals prevail.”
2. Homeopaths in Germany have been recognised since 1939
In Germany practitioners of homeopathy who are not medical doctors have been regulated by theGovernment since 1939 through the provisions of the Heilpraktikergesetz law. Reference: Gesetz uberdie berufsmäßige Ausübung der Heilkunde ohne Bestallung (Heilpraktikergesetz) vom 17.02.1939(RGBL. I S.251), geändert durch Art. 53 des EGStGB vom 02.03.1974 (BGB1. I S.469).
3. Almost 20 years of positive regulation of homeopathy in the Netherlands
In 1993 the Dutch Government changed its laws to permit the practice of CAM by practitioners who
are not doctors where this had previously been illegal. Homeopathy can be practised both byhomeopaths and medical doctors. Reference: Beroepen in de Individuele Gezondheidszorg.
4. Homeopathy legalised in Belgium since 2000
In 2000 the Belgian Government changed its laws to recognise the practice of homeopathy,acupuncture, osteopathy and chiropractic where this had previously been illegal.
Homeopathy can be practised both by homeopaths and medical doctors. Committees are in the processof being established in order to register and regulate practitioners of these therapies. The LigaHomeopathica Classica (LHC), the Belgian homeopathic ECCH/ICH member association, wasofficially recognised by the Belgian Ministry of Health in 2002 and the right of homeopaths who aremembers of the LHC was confirmed in a Royal decision published in February 2007.
5. Homeopathy legalised in Portugal in 2003
In 2003 the Portuguese Parliament introduced a new law that recognises the practice of homeopathy
and five other CAM therapies. Homeopathy can be practised both by homeopaths and medical doctors.
The new law enshrines the right of Portuguese citizens to freely choose the particular therapy theywish while also setting out the basis for the regulation of the practitioners who may practise thesetherapies as independent health care professionals. References: Project of law Nº 263/IX for framing
the base pf the Non-Conventional Medicines. Project of law Nº 27/IX Legal procedures of the NonConventional Therapies. Law 24/2003, Decree 28/2006.

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6. CAM law and public register in Norway from 2004
A new law was put into action from 1 January 2004 which clearly permits the practice of alternative
therapies by someone who is not a statutorily regulated healthcare practitioner. An official register forpractitioners of alternative medicine was established on 1 June 2004. The register is voluntary and theprofessions are self-regulated. Homeopathy can be practised both by homeopaths and healthcare
practitioners. References: Lov om alternativ behandling av sykdom mv. Register for alternative
behandlere at www.brreg.no. The Government in Iceland in 2005 introduced regulatory legislation
practically identical to the Norwegian law.
7. CAM register in Denmark from 2004
An official register for practitioners of alternative medicine was established on 1 June 2004. The
register is voluntary and the professions are self-regulated. Minimum requirements for medical
training have been set. Homeopathy can be practised both by homeopaths and medical doctors.
Reference: B 47 (som vedtaget): Forslag til folketingsbeslutning om en registreringsordning foralternative behandlere. Vedtaget af Folketinget ved 2. (sidste) behandling den 10. april 2003 at
http://www.ft.dk/Samling/20021/ beslutningsforslag_oversigtsformat/B47.htm).
8. United Kingdom Government and House of Lords agree homeopathy can be practised byboth homeopaths and medical doctors
The United Kingdom Government has recommended acupuncturists and herbal medicine practitioners
to achieve statutory self-regulation for their professions, and homeopaths were recommended toseriously consider achieving statutory self-regulation in the future. The Government’s
recommendations support the UK House of Lords Science and Technology Committee report that waspublished in 2000. Homeopathy can be practised both by homeopaths and medical doctors.
In the UK House of Lords Science and Technology Committee report on CAM it maderecommendations for investment in research into CAM, the improved education and regulation ofCAM practitioners, greater awareness amongst doctors of CAM, the inclusion of well proved andwell-regulated CAM practices in the National Health Service. References: House of Lords, Scienceand Technology – Sixth Report, November 2000.
9. Irish Government introduces positive regulation of homeopaths
The Irish Government is in the process of positively regulating the homeopathy profession and theECCH/ICH Irish association has a seat on the formal advisory committee. References: Report on theRegulation of Practitioners of Complementary and Alternative Medicine in Ireland, Health Services
Development Unit, 2002; Report of the National Working Group on the Regulation of Complementary
Therapists to the Minister for Health and Children, December 2005.
10. Homeopathy is being practised by homeopaths in most EU Member States
In most EU Member States homeopathy and other CAM therapies are legally practised bypractitioners who are not statutorily regulated healthcare practitioners. In France, one of the few
countries where such practice has until now been banned, the Government has recently moved topositively regulate osteopaths and chiropractors where previously such practitioners practised
illegally.

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Appendix BHomeopaths do not carry out medical diagnosis
As part of homeopaths’ bounds of competence ECCH and its member associations are clear that individual
practitioners should not carry out medical diagnosis. Homeopaths rely on each patient they treat having
access to the services of a qualified medical doctor for this purpose and for conventional treatment when itis needed. This has been recognised in two ECCH policy documents (European Guidelines for Code ofEthics, November 2002; ECCH Bounds of Competence, May 2006). The following is stated in these twodocuments:
ECCH recognises that it is in the best interest of patients for homeopaths to be aware of their boundsof competence. This has been agreed in principle in ECCH’s Guidelines for Codes of Ethics:• ... the practitioner to recognise the boundaries of professional competence including:- being informed about national legal requirements for practice- recognising when referral to other healthcare practitioners is appropriate/necessary due tolimitations in their own knowledge, skills and experience- being informed about the regulations concerning notifiable diseases and potentiallyproblematic therapeutic situations (working within the legal framework of the country)
The responsibility for adjusting the dosage or stopping any medication not prescribed by thehomeopath should be left to the patient in consultation with the prescribing practitioner. Homeopaths
should also know when a patient’s condition• is beyond the limits of their clinical competence• would benefit from another form of treatment• shows symptoms which suggest an underlying condition which requires referral for investigationand medical diagnosis
The Education and Training of Homeopaths
As the Council of Europe pointed out in its 1999 resolution on non-conventional medicine (seeattachment A), homeopathy is one of the four best established CAM therapies in Europe and these
therapeutic disciplines can be practised by doctors of conventional medicine as well as by any welltrained practitioner of CAM. Patients could consult one or the other, either upon referral by his or her
family doctor or of his or her free will, should ethical principles prevail.
The competency of practitioners should be ensured through their basic education and training. In orderto ensure this essential competency, ECCH has developed guidelines for the education of homeopaths(European Guidelines for Homeopathic Education, June 2000).
Criteria should exist for the education and training of homeopaths, both for practitioners who havebeen fully trained in homeopathy as a discrete clinical discipline and for healthcare practitioners who
undertake postgraduate homeopathy training. This is essential in order to ensure that thesepractitioners provide high quality effective and safe treatment for their patients.

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