Positive Health Online

Midwives' Concerns about HIV Testing

Jody and Michael (not their real names) have just gone into hiding with their five-month-old daughter. Shortly after they
left, the police turned up at their London flat. Their crime? Refusing to comply with a High Court ruling that their daughter must be tested for HIV.

HIV-positive

The story begins in 1989, when Jody became HIV-positive as a result of a sexual relationship with an HIV infected man. She was told by doctors that she had, at the most, ten years to live. But Jody became sceptical about orthodox treatments and concentrated on adopting a healthy lifestyle, nurturing a positive attitude, and using complementary therapies. Ten years later, she is completely healthy and more sceptical than ever, not only about the drugs used to treat HIV/AIDS, but about the whole diagnosis.

Jody and Michael (who is not HIV-positive) decided to have a child, and Jody became pregnant last year. Fearing the response of healthcare professionals, she did not attend for antenatal care. When she was eight months pregnant she found an NHS midwife who would attend her at home, She did not inform the midwife about her HIV status and, on 8 April, her daughter was born naturally, as both parents wished. She has been breastfed since birth, and is healthy.

Jody's HIV status came to the attention of her GP ten weeks later, when she took her daughter for a check-up. The GP wanted Jody to stop breastfeeding her baby and to agree to an HIV test; the couple refused. Shortly afterwards, Camden Council applied to the court under the 1989 Children Act for an order to test the child. Their application was successful, and at the end of August the parents were ordered to bring their daughter for testing by 17 September. The judge had made clear that, if the test were positive, the court 'might well order monitoring, including further regular testing; and that, if she (the baby) went into decline, it might well order combinationtherapy.'[1] The parents were aware that if the baby tested negative, they would be under very considerable pressure for Jody to stop breastfeeding. Although the judge proclaimed he believed that: 'the law cannot come between the baby and the breast', they were also aware that a judge in the USA has banned an HIV-positive mother from breastfeeding her baby,[2] and so conceivably the same could happen here. From the parents' point of view, therefore, whatever the result of the test, the consequences were unacceptable to them: they opposed testing because they opposed the inevitable sequel to testing.

Everybody seems to agree that the parents are loving, sane and very well informed. A few days before the 17 September deadline, they went into hiding.

Best interests of child

What a wealth of dilemmas this throws up. While few would deny the mother's right to decide for herself how to respond to her own HIV-positive status, what about her rights in respect of her baby? The Children Act has clarified this area considerably. It is now recognised in law that while children are the responsibility of their parents, they are not their property. The state will intervene if it believes that the parents are not fulfilling their responsibility. However, the state recognises that being in its parents' care is normally the best situation for a child and so will only intervene if it believes there is strong evidence that to do so is in the best interests of the child.

Looking just at the issue of breastfeeding, presumably we can say with certainty that it is in the best interests of this baby for her mother to be prevented from breastfeeding? Well no, we can't. Looking at the evidence from published research should raise doubts in all but the most closed-minded.

Having read research papers, reviews, commentaries, government reports, WHO and UNICEF statements, it seems to me that all we can be certain of is that this is an area of uncertainty. No clear picture emerges of what the risk of vertical transmission from breastfeeding is; transmission rates vary wildly and it is impossible to judge how the findings from one part of the world will apply to another.[3] What is more, the effect on the risks of transmission of such factors as how long the mother has been HIV-positive, how she acquired the virus, and her nutritional status have not been determined. And so on. The beliefs of the researchers and other interested parties cover a vast spectrum. Opinion varies from those who believe that we can quantify the risk precisely and should do all in our power to deter HIV-positive women from breastfeeding,[4] to those who believe (as Jody and Michael do), that the evidence is compatible with breast-feeding having, in some circumstances at least, a protective effect against HIV infection.[5]

New evidence

And now, to make things even more uncertain, we have the recently published article in The Lancet[6] which puts a whole new slant on the debate. In this study of the infant feeding practices of 549 HIV-1 infected women it was found that exclusive breastfeeding carried a similar risk to no breastfeeding. It was the women who used mixed feeding whose babies were at a higher risk (about 5% higher) of passing on HIV to their babies. If the results of this study are confirmed by further research, then the message is to encourage HIV-positive women to breastfeed exclusively, so 'maintaining the overwhelming benefits of breastfeeding'.[6]

At least as puzzling as the mixed messages from the research, is the response from those who appear to be absolutely certain that breastfeeding by HIV-positive women is dangerous and irresponsible. Clearly, we have a duty to provide women with even-handed information if they are to make an informed choice, and that must mean sharing our uncertainty with them and supporting them in whatever decision they make.

Of course, the medical and scientific community expressing certainty in circumstances where we should all be expressing doubt is not new to midwives. As one commentator remarked, in response to the correspondence in this and the previous issue of The Practising Midwife,[7] 'Underneath the expert statements I detect the suggestion that women can make informed choices so long as they make what is professionally deemed to be the "right" choice. I have been a midwife long enough to recall
how often the "right" choice has proved wrong.'[8]

Listening

We do not yet know what the outcome will be for Jody, Michael and their daughter. In the meantime, all midwives who 'encourage' pregnant women to undergo HIV/testing – as the Department of Health urges us to – should be sure to let women know before they have any blood taken, that if they are found to be HIV-positive they will have no say over the testing and treatment of their baby, and may be prevented from breastfeeding. At least, until such time as those who make these kind of decisions on society's behalf pause from making over-confident proclamations and listen – listen to the research and listen to women. A good start would be to listen to Jody.

Jilly Rosser
Editor, The Practising Midwife.

References

1 Judgement in the Matter of C (a child) and in the Matter of The Children Act 1989. Before Mr Justice Wilson, Royal Courts of Justice, 3 September 1999.
2 McCarthy M. Judge in USA bars breast- feeding by HIV infected mother. Lancet 353(9163): 1506. 1999.
3 Dunn DT. A review of the statistical methods for estimating the risk of vertical HIV transmission. Int J of Epid.27: 1064-7. 1998.
4 UNICEF; UNAIDS; WHO. HIV and infant feeding: a review of HIV transmission through breastfeeding. Geneva: Joint UN Programme on HIV/AIDS, 1998.
5 Gordon Stewart. Emeritus Professor of Public Health, University of Glasgow and former HIV/AIDS consultant to WHO. Personal communication, September 1999.
6 Costuoudis A, Pillay K, Spooner E et al. Influence of infant feeding patterns on early mother-to-child transmission of HIV-1, South Africa: a prospective cohort study. Lancet; 354: 471-6. 1999.
7 Correspondence in the Letters Pages of The Practising Midwife. 2(8-9) Sep-Oct 1999.
8 Kirkham M. Professor of Midwifery, University of Sheffield. Personal correspondence, September 1999.

 

The above letter by Jilly Rosser was originally published as the Editorial in the October '99 issue of The Practising Midwife.

Compulsory HIV Testing: an Error of Judgement?

Mr Justice Wilson's ruling (Royal Courts of Justice, London, 3rd September, 1999) that a healthy baby born to an 'HIV' positive mother should be tested for 'HIV' was a gross error of judgement. The parents now seem to have fled the country thus missing their appointment to have their four month old baby daughter tested (which was set for Friday 24th of September, 1999).

Judge Wilson seems to have been misled concerning the spurious scientific validity of 'HIV' testing. As the mother stated in the Daily Mail (18th September, 1999): "In any event I think the tests are meaningless and not indicative of ill health".

This case has recently initiated the 'Group for Scientific Analysis of Fraudulent HIV Testing' to empower people to make truly informed choices concerning the fraudulent science behind so-called 'HIV antibody' testing.

All putative 'HIV' testing procedures (PCR/viral load/genetic) are non-specific, non-standardised and non-reproducible; different test kits give different results; and different countries have different criteria as to what constitutes an 'HIV' positive result. There are 60 conditions which are known to produce an 'HIV' positive result including: hepatitis, flu, autoimmune diseases, parasitic illnesses, fungal conditions, mycobacterium and candida ('Factors known to cause false-positive HIV antibody test results', Christine Johnson, Continuum Vol 4, No 3, 1996). The 'HIV' tests do not, and cannot, test for 'HIV' because such a hypothetical retrovirus has never been isolated. Prof. Gordon Stewart et al wrote in The Lancet (21st August, 1999): "…why has HIV never been isolated by electron microscopy or gradient ultracentrifugation from co-culture cellular material from any African patient?" Or from anybody else worldwide? The fact is that 'HIV' particles have never been seen, isolated, or recovered from uncultured blood or plasma. Prof. Gordon Stewart also argued in Current Medical Research and Opinion (Vol 13, No 10, 627-634, 1997): "At present there is no scientific basis for using these tests to prove HIV infection." At the Geneva World AIDS Conference, 1998, Day One Session 'HIV Testing – Open Questions on Specificity', it was stated: "The meaning of currently used HIV tests is unknown and urgent reappraisal is required."

To date, Robert Gallo, Luc Montagnier, Jay Levy, Richard Tedder, and Robin Weiss have not proven that 'HIV' exists as a unique, isolated/purified retrovirus. In the light of hard scientific data it is unethical, misleading and irresponsible to promote overtly fraudulent 'HIV' testing.

Anyone requiring further information can contact our group at the following address:

Knowledge is health is power.
Alex Russell, Assistant Editor , Continuum Magazine.
The Group for Scientific Analysis of Fraudulent HIV Testing,
c/o Continuum, 4A Hollybush Place, Bethnal Green, E2 9QX.
Tel: 0171 613 3909 Fax: 0171 613 3312 email: continu@dircon.co.uk

Safety of AZT in Doubt

Not only may the scientific evidence for HIV testing be questionable, but the safety of the standard treatment is increasingly in doubt, as reported in New Scientist 2 October 1999. Nucleoside reverse transcriptase inhibitors (NRTIs such as AZT) were originally developed for chemotherapy in cancer patients but were never used as they were found to be too toxic. This class of drugs was already known to have many serious side effects, cause birth defects, to stunt development, and to be carcinogenic. In a paper in the Lancet (Brinkman K et al. Persistent mitochondrial dysfunction and perinatal exposure to antiretroviral nucleoside analogues. Lancet. 354(9184): 1112. 25 Sep 1999), Dutch AIDS specialists claim that a number of side effects associated with HIV treatment could be caused by damage to the mitochondria. Mitochondria are the structures in cells which provide the energy for all the cell's activity. The author of the paper states "I strongly believe that NRTIs are much more toxic than we considered previously."

Channel 4 requires your help

Channel Four is making a season of programmes about food and our relationship to food today. I am researching one of the programmes in this season in which we are going to follow a range of people's relationship to food. We are trying to find people who have had a difficult relationship with food, for example yo-yo dieting or chronic health problems, and are now trying to tackle these problems through a change in diet or new regime. The programmes will be quite intimate and personal in style, following the story over a period of time and possibly asking the contributors to keep a diary of their diet and their thoughts and feelings about food.

Lucy Swingler,
Researcher.

Are you aware of how the food you eat affects you?

Are you concerned about eating the right things?

Have you changed the way you think about food?

We are currently researching a programme for Channel Four TV about people's relationship with food. We are hoping to speak to people with strong views on eating healthily and who live their lives accordingly.

If that sounds like you, we'd love to hear from you.
Please call Lucy or Fergus for a chat on 0117 311 8403/8409

The Sad State of Complementary Medicine

Thank you for your Editorial in Issue 43 (August 1999). You address a sad and increasingly disturbing situation in the complementary medicine world. Many, in and out of it, are dismayed by what is going on but feel unable to find a way to change things before it becomes too difficult to do so. It is a subject that would benefit from an edition or an article of its own. Your editorial is a start and is to be applauded.

Clare Petrie
17 Quality Street, Edinburgh, EH45

A Plea for Higher Standards

There have been several articles in Positive Health, including the editorial in Issue 43, about the infighting and schisms within particular disciplines and within complementary medicine as a whole. I find myself in two minds over the issue. All those who genuinely have the best interest of their patients and clients at heart should be supportive of each other, especially if they share the knowledge and experience of a particular therapy. There is no shortage of people willing to criticise complementary therapists from the outside; why should we feel the need to add a critical chorus from within?

Yet it is precisely because there is a perpetual open season for the criticism of alternative medicine that it needs to be even more careful of everything that it does than conventional medicine. There are far too many therapies and subdivisions of therapies that do not have a foundation in empiricism and philosophy. Even in those therapies that have solid foundations too many practitioners choose to ignore them and practise by groundless whim. Alternative medicine does not have the power of industry and the establishment that conventional medicine uses to explain away any lapses. Every time a second-rate therapist fails a patient, he or she damages everybody involved in alternative medicine.

Within my own profession, homeopathy, there are disputes but also a movement towards unification and standardisation. I support my fellow homoeopaths and would wish that we all prosper together. However, every time someone who goes by the name of homoeopath makes a prescription that is not soundly based in philosophy and reason, not only is the patient damaged, but so is homoeopathy and so am I. In such a situation criticism becomes a duty to the public and to the profession I love.

Peter Fraser, Homoeopath
Bristol.

Strange but True

I enjoyed reading the letter in Issue 44 Coincidence or a Tale of the Unknown. I enclose a similar tale which I thought might be of interest to Positive Health readers.

Several months ago I was discussing dreams with my mother who is now seventy-nine years of age. She turned to me and said, "I will tell you something that I have never ever told anyone about". This is what she told me.

During the war years she had two boyfriends, my dad and a young man named Stanley, who was her brother's friend. Neither of the relationships were serious; she would date whichever one was on leave. Unfortunately Stanley was killed in action. Her relationship with dad became more serious and eventually they married. Dad remained in the army after the war and they travelled to many countries. Dad was a fiery Scot with a fiery temper and mum's life was not always very easy, especially with five children to rear. Over the years she would sometimes have dreams in which Stanley appeared, and upon awakening she would always know that that day there would be a row of some sort. Her prediction was always correct.

One night in early 1982 mum had a dream. Stanley was standing at a bus stop, mum was further down the road, she urgently wanted to speak to him and ran and ran towards the bus stop. When she was almost there the bus arrived and Stanley jumped on board but he then turned around and smiled at her and waved goodbye. The following day my dad died suddenly without any warning. Mum has never since dreamt of Stanley! Was he her guardian angel? Strange, eh?

Jenny Holmes
Huddersfield

Response to Kesselring

On page 39 of Positive Health Issue 43, you invited responses from reflexologists regarding Kesselring's research of foot reflexology on recovery following surgical intervention.

Firstly, let me introduce myself: I'm Ros Seymour, a Bayly School of Reflexology trained clinical reflexologist, Member of the British Reflexology Association and Lecturer in Complementary Therapies at the University of Huddersfield School of Human and Health Sciences. I work as a reflexologist in the Occupational Health Department of Huddersfield Royal Infirmary, and also at Pennine AIDS Link, where I work with people with HIV/AIDS and their carers, in addition to running a private practice.

There tends to be an assumption that allopathic medicine is well researched and proven, and that "complementary" medicine will only be taken seriously and accepted by the establishment if it is researched and proven. I take issue with this for a number of reasons:

The research base for allopathic medicine is not all that it seems. For example, it is by no means uncommon for drug testing to be abandoned at the first sign of favourable results, usually with comments such as "it is simply too good a product to withhold – we had to make it available as fast as possible". Which roughly translates as "we can make lots of money from this, never mind the long term consequences". The potential for a drug to harm is far greater than any possibility of reflexology being harmful yet new, inadequately tested drugs are simply accepted while reflexology is not.

Given that allopathic medicine is not so very well researched and proven as the establishment would like us to believe, it seems incredibly arrogant of the establishment to insist that complementary medicine should comply with their dictates to produce evidence of effectiveness. Despite the use of the term "complementary", the fact remains that allopathic medicine and holistic medicine are worlds apart. Why should we change to suit a medical establishment which the public is increasingly disenchanted with? And change is what we have to do if we let ourselves be researched using methods more suited to allopathic medicine.

The problem with attempting to use scientific methods of analysis to research holistic therapies is that science simply hasn't progressed far enough to encompass the concept of holism. (If it had, I strongly suspect allopathic treatment would have been given up as a bad job – perhaps that's why science hasn't gone down that road.) You simply can't assess the effectiveness of reflexology by applying the rules of science.

"Double blind" studies are a nonsense, because any form of nurture is likely to have some positive effect on a person's health. Timescales are usually inappropriate, as holistic therapies aim to correct imbalances, and that can be a lengthy process.

If a condition is a physical manifestation of, say, anxiety, that physical condition will not show improvement until the anxiety has been treated. Therefore, a course of treatment could be progressing well with the anxiety showing noticeable signs of improvement by the end of the research period, but because the symptom has not yet improved the conclusion would be that reflexology had failed to treat the condition.

It is a cause of concern to me that I am unable to produce evidence to back up my observations that reflexology works. I would willingly submit my practise to scrutiny if and when science is able to recognise the nature of subtle energy, and a more appropriate means of conducting research has been identified.

I would very much like to read Kesselring's full research report – would you be able to advise me where I could obtain a copy? Without reading the whole thing it is difficult to make accurate comments, but the following observations spring to mind:

Reflexology was carried out only for a few days… I'd be hard pressed to achieve any improvement in a few days, particularly if the patient had just undergone the trauma of major surgery. I would not normally treat on a daily basis – weekly or twice weekly is appropriate. If I were treating daily (perhaps an injury that needed to be healed in time for the client to participate in a sporting event, or perform on stage) I would only do so if the client was in good general health, and certainly not after major surgery.

Were the treatments carried out before or after surgery, or both? I notice the measures were recorded from the day prior to surgery – if the treatment was started then I would say it was too little too late. I have treated people prior to surgery (fortnightly treatments for 2/3 weeks) paying particular attention to the respiratory system and reflexes associated with the area to be operated on. I have treated three such clients in the past six months, and all reported that their recovery from anaesthetic was quicker than usual (nursing staff had commenting on this on two occasions). One client in particular usually reacted adversely to anaesthetics, but was fine from the moment she recovered consciousness.

All three clients mentioned above also received treatments after their operation (the number and schedule of treatments varied according to the individual). They each felt that their recovery from the operation in terms of speed of regaining mobility, speed of being able to return to work, and healing of scars seemed to be improved with the reflexology. No one reported any negative effects.

One of the clients referred to above was operated on twice within the six month period, initially for the removal of an ovarian cyst and subsequently for the removal of the ovary with a view to alleviating debilitating pain. She came to me three weeks prior to the first operation so I did not have the opportunity to treat the condition itself, but she did comment that the pain seemed to decrease after each treatment. The post operative pain certainly seemed to be relieved by reflexology, and in fact I taught her how to find her solar plexus reflex on her hand, which she was then able to use for pain relief.

I'm therefore not sure why Kesselring asserts that reflexology could trigger abdominal pain. If a "healing crisis" is going to occur it will invariably do so in the early stages of a course of treatment (often after the third session). I would question the wisdom of starting a course of treatment the day of (or day prior to) major surgery for this reason, and also because of the strain it is putting the patient under. To start off a natural healing process and contradict it immediately with the trauma of surgery seems counterproductive. Could this be the reason for Kesselring's results? Maybe the course of treatment should have been started earlier. Perhaps gentler pressure should have been used on the reproductive reflexes. (I find that this usually prevents healing crises – it's rare for my clients to experience them). It is difficult to comment without having the full research in front of me.

Kesselring's conclusion is based on the "occasional" negative effect of abdominal pain being triggered. Reflexology did have "various effects" not all of which were negative. Were these taken into consideration when reaching the conclusion? What were the other effects? Why was the occasional abdominal pain thought to outweigh the other effects?

"Simple massage was a relaxing positive experience…" Reflexology is usually a relaxing positive experience… There is a school of thought that holistic therapies "probably won't work, but can't do any harm". Reflexology is a very powerful therapy that does work, and its effects can be quite startling for someone not expecting it. Is Kesselring implying that massage was okay because it didn't have any effect, but reflexology should be avoided because it is effective? Maybe I'm reading that wrongly – as I said it's difficult without having read the full report.

I'm not entirely surprised by the findings. As I said, I don't think that scientific research can cope with the way in which reflexology works. My experience of treating gynaecological conditions is that reflexology is incredibly beneficial, and has prevented some clients from having to accept surgery. I also find that reflexology is effective in assisting recovery from surgery, and have never encountered negative responses in these treatments.

What we need is some large scale studies into the long term effectiveness of reflexology, not 11 day research projects which cannot hope to accurately assess the therapy's effectiveness. Personally I'm beginning to think there could be a link between reflexology and HIV viral loads decreasing to undetectable – I would desperately like to examine this, but the only way I can see to do it is to set up a major study over a long period of time, making comparisons between those having reflexology and not, and those taking combination therapy and those not. This would need major funding, and I can't find anyone prepared to provide this because short, inaccurate research projects cost less money and produce quicker results. I digress, but I just wanted to make the point that I'm not anti-evidence based practise, just concerned about scientific research.

Ros Seymour MBRA

Tests Unsatisfactory

Re: Kesselring – Possible usefulness of foot reflexology on recovery following surgical intervention – Positive Health. August 1999. Research Database p.39.

These thoughts/observations are in response to your invitation to comment about the published précis of the above subject.

The application-time was very brief, only a few days for each of the 130 patients within the study. Presumably the treatment sessions were brief – as appropriate to an immediate post-operative condition.

It is not very satisfactory that the measures recorded until day 10 were self-assessed because the after effects of full anaesthesia could have affected objectivity. Equally, it is not clear whether pain intensity was assessed on a scale 1 to 5 or 1 to 10, for example.

The 'conclusions' are surprising in that the non-recommendation was based upon occasionally triggering abdominal pain. I see that as a healing crisis rather than as a contra-indication: it is very probably part of the physiological re-balancing necessary to restore these patients to full health and vigour.

I have limited experience of using reflexology pre-surgery – to build the person's immune system (for example) and general health and post operatively, to assist recovery. There would appear to be limited help in working post operatively only.

Adrian M. Seager Msc, MIIR (Regd), ART Reg (Hons), BRCP, MAR.

Statutory Self Regulation and Bust?

Provisions in the recent Health Bill indicate a simplified approach to statutory self regulation and protection of title for complementary therapies. The 1997 University of Exeter Report suggested criteria for self-regulation and these have been adopted by the Foundation for Integrated Medicine. In the May 1999 Consultation Document from Healthwork UK, the new name for the Health Care National Training Organisation, the same basic thinking prevails.

Excellent news, and we all applaud the move to bring complementary medicine to the forefront of health care in the next millennium, but is there an flaw in the basic thinking behind the recommendations for self-regulation?

The premise that each individual therapy, be it aromatherapy, reflexology, massage, nutrition or any one of a growing number of therapies reaching public popularity and endorsement, requires a quite separate organisation to facilitate regulation and registration does not stand up to close scrutiny.

At first glance perhaps a good idea, some may say the logical next step; but have the architects of these schemes stopped to look at complementary medicine and the way it actually operates in the UK? We applaud the success of the osteopaths and the chiropractors and maybe their success is the guiding light in suggesting a similar organisational route for complementary medicine, but do not the osteopaths and the chiropractors consider themselves alternative rather than complementary practitioners?

And complementary therapies cannot be neatly packaged in the suggested way and the briefest of market surveys immediately highlights the problem – the majority of practitioners in complementary medicine are multidisciplinary with a number of distinct therapies at their disposal and used in their daily practice.

Let us for a moment dwell on the osteopaths who now have a single Council and we learn the cost to register has been set in the region of £1,400 over the first two years. It becomes immediately apparent the effect such a levy would have on practitioners in complementary medicine if they had to pay a similar scale of fees for each therapy they practised – they would simply not survive financially.

The average complementary therapist does not earn upwards of £20,000 per annum, and even a scale of fees set as low as half the osteopath's rate would still be a crippling burden for many of today's therapists who bring a diverse range of skills into their daily practice for the benefit of their patients.

An Alternative Strategy is to qualify as a practitioner in complementary medicine, and then to be Registered in one or more specific complementary therapies. Effectively this will create a Council for Complementary Medicine, a single Registration and Regulating body with specialist therapy groups. One basic registration fee with additional modest charges for two or more therapies, a single contact point for public referrals and probably of greater importance, one source for complaints and disciplinary procedures across the whole range of regulated therapies, essential for public safety.

There is no need for such a body to be a huge bureaucratic monster and its responsibilities would be limited to self-regulation and registration, nothing more, nothing less.

Healthwork UK's approach to the formation of lead bodies and their 'heads of agreement' option, which allows for existing associations representing practitioners in a common therapy to work together to become the lead body for the therapy, makes a lot of sense and sits comfortably with this alternative strategy. We already have an excellent example of this arrangement in action with the Aromatherapy Organisations Council (the AOC) where we understand the different associations who make up the AOC have agreed to hand over their regulatory powers at the appropriate time, whilst retaining their own identities.

It is important that we retain strong associations to continue to provide professional support for their members, to arrange their professional insurance, support research activities, monitor and provide ongoing professional training and development and the hundred and one things an association provides for its members.

It is equally important we have a strong regulatory body to protect public safety and the proposed alternative strategy will provide the structure that protects the patients and at the same time gives the best possible support to the multidiscipline complementary therapist – and that we believe is the majority.

John W Beney, General Secretary,
Guild of Complementary Practitioners

Matter of Opinion

In response to John Wilks' letter (Issue 45) I only have one comment and one suggestion.

He thinks that clauses 3.1 and 50.1 contradict each other. I don't think that they do: in practice 3.1 applies to all advertising – if something is presented as a fact, advertisers should be able to prove that fact. 50.1 is more specific in relation to dealing with physiological claims – which, in order to establish those facts should be backed by trials.

My suggestion is that you publish the telephone number for the CAP Copy Advice Team. Both the ASA and CAP want to help advertisers get their message across without misleading anyone. The CAP Copy Advice Team, on 0171-580 4100 (Tel) or 0171-580 4072 (Fax) would be happy to look over any draft copy from complementary therapists. They offer free and fast advice, which is confidential from competitors. I'd be grateful if you would publish those numbers in your magazine.

Chris Reed
External Affairs Manager
ASA