MEDICAL LAW.

Dominion, Volume 2, Issue 450, 8 March 1909, Page 5

MEDICAL LAW.

MUCH NEEDEfr AMENDMENTS. OPPORTUNITIES TO "QUACKS." PLAIN TALK FROM DOCTORS. In a leading articlc, last week, The Dominion stated "Whether the law which permits strangers to como to the country and practise the art of healing without further credentials than their own professions, is a wise one may well bo open to ciuestion. Tho Health Department exists in the publio interest, and it should v be placed in a position to exercise some control in matters of the kind, but apparently at present it is quite helpless. Until tho law is amended, the credulous section of the public must talco care of themselves." It is satisfactory to noto that tho views expressed by this paper arc strongly endorsed by tho medical profession, representative members of. which discussed this question at the conference of tho New Zealand sectionoorthof r tho British Medical Association, held very recently at Napier. Tho inadequacy 'of present legislation to protect the community, not only from quacks, but also from occasional unscrupulous members of the medical profession, was then emphasised in tho strongest terms, and cases of neartles3 imposition were cited which could hardly happen in a community where proper legislation was in force. The discussion was aot telegraphed at any length when it took place, but wo aro in a position to give today a summary of tho speeches, as obtained from an official source. Defects of tha Lav;. The subject was introduced by a paper read by Dr. Gibbs, of Wellington'. Ho stated , that periodically the council of the association came face to face with clauses in tho Act which produced a complete deadlock. In one ease, a recognised quack could not bo removed from tho register, and was still among the registered practitioners of the Dominion, and in another instance a man, who had been struck off the register, not only enjoyed the utmost freedom of practice, but oould still compel tho authorities to put his name on the telephone-list among tho registered medical practitioners. Were there no other reasons, these were enough to make the association look into the law which affected medical practitioners, and consider carefully whether it needed amending, and how best to set abput it. In the first place, the law was enacted in 1869, and it was doubtful if mj' law had had such little attention paid it, either in its drafting; or in its subsequent history, as the only timo it had been amended was three when the five years'i study clause was inserted. Both \as regards the protection from abuso vithin tho profession and- tho protection of tho publio from abuse, tho law was absolutely useless. Practitioners Need Not Be Registered. As to tho raoro glaring; defects of the pre- : sent'-law, registration might be mentioned. . At present it was not, compulsory to register ; in order to practise. A plumber could not .

connect up a drain without being registered, a cabman could not ply for hire, nor even a Jog walk the streets without registration, . and yet the law allowed medical men to pratise 'their profession without making registration compulsory. "What waß worse, the very law under which a person who for any crime was rtruck off the register was ttill allowed to practise. The law did not think him good enough to hold public appointments and sign certificates, but lie was good enough to still treat the public, practically absolved from the restraints that would ordinarily keep him to the mack/ True he was practis- , ing wider a few disabilities—ho could not, for insta ce, hold public appointments, nor . sue for his fees, nor sign certificates, but he could do very well in spite of these limitations. ihe trouble over signing a death certificate was the only serious one, and this apparently only because a case had never been tested. Surely, the speaker urged, the association should insist upon registration being a sine qua non to practise, and that striking _ off the register carried with,it prohibition :to .engage in. the practice of the profession. Ib was a feature of the Medical Acts of Victoria and N.S.W., and the iniquity of it was that a man could be struck off the register in Australia and. be forbidden to practise in Great Britain, and yet he could come to Now Zealand and doman, according to our laws, to be registered. This had been done, and the association was powerloss to • remove the practitioner or prevent him from exploiting the public.

1 A Ridiculous List. Nearly 45 per cent, of the names on the Now Zealand Register ought not to bo there. Over 300 of tho 500 which constituted this' 45 per cent, were either dead, or had no address, or had left the Dominion without intention to return. There should, the 'speaker urged, bo some means of purging tho register of these names. \ Every year the position was necessarily growing worse. A large number on tha register weroi wandering "locums," who brought a boat out, got registered to tako a few "locums," and cleared out again. As: it stood at present, tho register was useless' for any purpose except for proof of registration in a court of law. There was no means at present of getting off tho register, except by committing a crime, or dying, and, in the latter ©vent, it • would' seem, it required a certificate in one's own lull as to death before the name would bo removed. ' It was c.iear that a great change was needed in the low relating to the medical profession, and a committee should bo formed to go- into the matter.. There wore excellent examples of legislation in tho Australian, States and in tho English Act, and moreover, thanks to tho association's former general secretary. Dr. Graham Campbell and, Dr. Mason, there was a splendid Bill ready to hand drawn up by. thenv in 1901 on tho model of the Australian laws. This provided for a Medical lioard with powers to conduct its duties under confirmation of tho Governor in Council, a control of tho register, and other clauses bearing out tho purport of the better parts of the present Act. In conclusion, the speaker formally moved: ' "That this meeting considers it necessary that immediate' steps bo taken to bring about an amendment of tho Medico Pra^ ltll ? ncrs Registration Act of 1369 on the lines of the Australian and Lnglish Acts, and that a conimitteo bo set up to further this object with tiie least possible delay.'

In the Interests of tho Public. Dr. Cahill (Wellington), in secdndine the motion, considered that some legislation in the direction indicated by Dr. Gibbs was absolutely essential. As regards tho attitude of tho profession towards tho public he believed the position was uniquo. Was there a charitable institution in the Dominion to which, when called upon, they did sot give their services freo? Had ever a man or woman in this country been refused medical aid on the ground that he or she could not pay for it? What would be tho Tesult if one went to a lawyer, or an engineer, a plumber, or a blacksmith and asked him to give his services freo in the way the medical profession didP Yet tho profession had to contend against continual misrepresentation. Quite recently thero appeared in many of the papers throughout New Zealand an advertisement in which it was claimed that a certain disease could bo cured without operation, and even some members of larhameiit pinned their faith on such an assertion. If members or ministers would only take the trouble to inquire of honest medical men they could never bo misled in that simple fashion. In conclusion, he had much pleasure in seconding Dr. Gibbs's motion, not in the interests of tho profession, but in the interests of tlje public. Dr. J. R. I'urdy (Lower Hutt) agreed j with Dr. Cahill that the reason tho medical' profession had Hot hitherto taken an active part in any campaign for tho suppression of the crying evils that existed wa3 that their motives would at. once lie misrepresented by interested parties. This they knew from previous experiences. He hoped that a strong committee would be formed which would place before Parliament such convincing evidence that no body of com-.

petent men could refuse, to tako tho necessary action to remedy tho defects in the present law. Dr. Do Lisle supported tho arguments of tho previous speakers, and was entirely in support of tho motion. Bogus Degrees. Dr. Stevenson (Christchurch) said in his particular branch of tho profession ho saw many very glaring instances of quackery. In tho newspapers throughout tho Dominion thero appeared advertisements daily that A, B, or C —with letters after his name — might be consulted on all cases of defective oyosight, that tho practitioner had tho advantage of 15 or 20 years' experience, and had mado a special study of the subject in England, on tho Continent, and in New Zealand. These men claimed to havo degrees which, on inquiry, might prove to bo "Eellow of tho Spectacle-makers' Company" or something of that kind. They had to pay something like £20 for the privilege of working in some optical factory for about three months. "D.8.0.A." ho understood to mean "Distinguished Brother of tho Optical Association." Tho mischief theso men wero doing camo home to ono every day. One did not mind n millionaire, or the man who had his thousands, being gulled, as ho believed somo of them liked to bo gulled, in this fashion; but in the case of the poorer people it was a very different matter. These men not only charged for their spectacles, but tho doctor's fee as well, whenever they could get it. People going to these men invariably came away with spectacles, whether they required them or not. He would like to give one or two instances out / of a good many that had como under his notice. "Improving" the Eyesight.

Only a week ago a poor, neurotic woman came to the hospital wearing a plus cylinder in one eye, nnd in the other a prism, of minus 4 diopters. She had no eyo complaint whatever. She had been told to wear theso glasses constantly, and she was trying to do so. The result was the woman suffered from giddiness, constant headache, and sickness, and was a complete wreck when sent to tho hospital by a medical man. In other instances of grave refractive errors and myopia, there wero cases going to these opticians for glasses. When l there might be. a refractive error of 15 or 20 degrees it would be sometimes found that tho patient was wearing a plus lens when ho should bo wearing a minus one, ana vice versa. And from timo to time these people went back to tho optician to havo their glasses changed. Ho know of cases going to. these men every two months to have their glasses changed, and their being told that their eyesight would gradually improve, and ultimately they would see perfectly well. One of the cases was led

up to the hospital completely blind. Slio had been going to one of these men for 2i years—a man who called himself a doctor— and she was under tho impression he was the ablest man in New Zealand, because he had told her so. The case was perfectly hopeless. It waa a caso of glaucoma. The poor woman naturally wanted to know why the authorities did not take this matter up and put a stop to these frauds which were being daily perpetrated upon the public. It was true that most cases of glaucoma were hopeless, especially traumatic, but thero a fair number which recovered under medical treatment. In this particular case there was no chance of recovery. The next day her sister came to the hospital. She was blind in one eye and was gradually growing blind in tlio other. Slio also had been going to the samo man to have' her glasses changed every two'mouths, and had been charged 7s. 6d. each time, simply for altering them j the cost to the optician was Is. Gd. She paid him an initial fee of £1 Is., and frequently afterwards sums of lUs. 6d. and 7s. Gd. for advico and having her glasses changed. In this case .he found it necessary to operate on the cvo. Tlieso men were actually allowed to send around circulars, m which they claimcd- to havo special knowledge in the treatment of the eye, and only recently he foiind one of them under his door. A short time ago he had —> urging that some-

thing should bo done to prevent men of. this class from going into the public schools and testing the eyesight- of the children. In the'particular .case mentioned in the letter the man. went into the school and 'recommended, nearly ;.every child in the . school to wear glasses. If his colleagues were present thoy'would bear hirn out. in saying tlint "nearly ovcry day of the weolc they were casting off glasses which were not needed, and this so-called eyo test was one of the most glaring cases or fraud that could exist in any country. Present Act a Disgrace.

Dr. Mason, Chief Health Officer, said, as ono who had taken some littlo trouble to try to get tho law placed .on a better footing ho must cordially endorse what had fallen from tho previous, speakers. The pre-' sent Act was a disgrace to any country. It was framed almost entirely for the protection or the peoplo who wore committing frauds. lortunately the Legislature ha 3 recently been passing ■ some measures which would help them considerably. For instance, the oale of l'ood and Drugs Aot, and even the emasculated Quackery Prevention Act W u]i inu °h> it was truo. i as all the vim had been taken out of them before they were place on the Statute Book. At -he present time, unless a man behaved in such a way as to convey to tho Court the idea that he protended to bo a re°-is-be could do allying he lilted. There were many flagrant forms of quackery unchecked in this country to-day. Dr. Gibbs had mentioned ono cas6 ot a particularly glaring nature that went to show the insufficiency of the present Act. Public Easily Culled. To show how. easily people woro taken in by quack advertisements ho was fortunate enough on one occasion to bo ablo to show upon a, screen tho invitation of a cortain Lady —- to ladies to send along thoir symptoms to her, with a guarantee that they Znl + Tf d ' Bld8 I b f "do with a photograph of that same lady s tombstone, certifying that she had been properlv buried for 2o years.

,A person shall be.deemed to take and use a title, name, style, or' description who advertises, exhibits, or holds out, or is party to tho exhibition, advertisement or holding out, of any title, name, or description of, or concerning, any institution, company, association, body, place or premises, whereby it is directly or indirectly expressed or implied that medicine or surgery is practised there, or who carries on or is party to tho carrying oil, by or at any such institution, or under or in connection with such institution, company association, body, place or premises, tho practice of medicine or surgery, or any branch of medicine or surgery." If some such clause as that were passed by I an.ament the profession would bo satisfied Although incidentally tho medical profession might benefit by such a law, it would be far more in the interests of an unwitting public. Statement by Minister. The Hon D. Bnddo (Minister for Public Health) B aid he had listened with great interest to the discussion which had taken Place/ and to the various cases which had oeen placed before the conference as illustrating tho necessity for an alteration in tho law. Iho suggestions contained in tho L.ll referred to seemed to him to meet tho position. Iho medical profession would, he in +l?o r &ii nSre ° , t lal ;. t,lc proposals embodied m the Bill, would, it passed into law, bo a gieat improvement at any rate on the present registration system, AVith. a few slight amendments, he thought this Bill suggested a very praCcal method of dealing with sonic of the outstanding defects with which every medical man had to contend. On tho question being put, Dr. Gibbs's motion was unanimously acrood to ,„?i J" 11 - it was resolved that t,o -chairman of council, tho past president, the president-elect, the secretary of the branch, and the secretary of tho ■?, !?. n ,vlslon a . committee to deal with this matter, the committee to have 1 power to add to their number.